GLOBAL MEDICAL INSURANCE®
Plan Options:BronzeSilverGold
PlatinumA W O R L D W I D E M E D I C A L I N S U R A N C E P R O G R A M F O R I N D I V I D UA L S A N D FA M I L I E S .

Global Medical Insurance®
Worldwide Coverage. World-Class Services.
Being a global citizen can be an exciting experience, but
it also comes with potential complications. Your healthcare should not be one of those concerns. With Global
Medical Insurance, a revolutionary program from
IMG® (International Medical Group®), you will receive
the worldwide medical coverage you need, backed
by the world-class services you expect.
Global Medical Insurance allows you to choose fromseveral plan options, areas of coverage, multiple
deductibles, and modes of payment. With your
medical history in mind, the program provides
different underwriting methods to extend medical
coverage to you that may be declined by other

SAFETY SOLUTIONS

Plan Highlights» Flexibility - Multiple plan options and payment modes to fit your budget» Choice of Coverage Area - Worldwide or Worldwide Excluding the U.S.,

companies. Quite simply, we help you build the cover
you need.

Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan

With IMG, you will rest assured knowing that wehave a dedicated department working to keep yourinsurance as affordable as possible. The costs of healthcare are rising, but we are committed to controllingthose costs.

» Freedom to Choose - Select your own health care provider, no matter where
you are in the world» Travel Intelligence - Receive location-specific alerts on health, transportation,
security, and weather» Assistance Services - Available on all plans» Preventative Care - No waiting period on wellness benefits» Healthy Travel Preventative Coverage - Receive vaccinations and preventative

You need the proper worldwide coverage, provided
by a company that’s there for you when you needus most. When you select Global Medical Insurance,
you receive IMG’s promise to deliver exceptional
medical benefits, medical assistance, and service—all
designed to give you Global Peace of Mind®.

prescriptions prior to departure» Pre-Existing Condition Waiver - For individuals with proof of comprehensive
health insurance and no significant break in coverage (63 days)

Products and services designed with your safety in mind.

No matter your reason for being a global citizen, we know your safety is important to you. IMG’s Global Medical Insurance has solutions designed to protect you and give you Global Peace of Mind.
PHYSICAL HEALTH
You can’t plan when you get sick, and unfortunately, it can happen anytime andanywhere. Medical bills can be expensive, and IMG plans provide the cross-border
medical coverage you need for unexpected medical care and routine visits.
MENTAL WELLNESS
Being away from your support system can be challenging. IMG provides access tomental health services, like virtual counseling, to help with the transition as you
adapt to cultural differences, adjust to a change in job or education, and navigate
new relationships while you’re away from loved ones.

CRISIS SUPPORTNavigating an emergency in a foreign country is never easy. That’s why IMG offers a
travel intelligence app to warn you of imminent dangers and security threats. Plus,a multilingual staff of nurses, doctors, and case managers provide 24/7 assistanceservices to facilitate a response to urgent and emergency situations, such as
evacuations or search and rescue missions.
PERSONAL PROPERTY
There are some belongings you know you can’t live without. IMG has you covered
and can reimburse costs if your mobile device is lost, stolen, or damaged during yourtravels abroad.

FINANCIAL PROTECTION
Costs can add up while seeking medical treatment. However, access to IMG’s
international physician and provider networks and pharmacy discount programs
can help you save on out-of-pocket medical expenses and prescription medications.

2

Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way the Certificate of Insurance andgoverning policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

The
AdvantageSERVICE

Our Service, Strength, and Safety Solutions provide youwith the ultimate advantage: Global Peace of Mind.

Help when and where you need it.

Nobody wants to experience an emergency while traveling the world, but if you do, you’ll want ateam you can trust to have your back. IMG’s expert staff is here for you 24/7. We’re accustomed toworking in multiple time zones, languages, and currencies, so rest assured we have the training toassist you—even in remote and hazardous locations. Our international and U.S. provider networks
include more than one million physicians and facilities across the globe, giving you access toquality care while away from your primary care team. Our innovative technology allows you tomanage your claims, your account, and search for providers through our online portal and mobile
app around the clock.

STRENGTH

A market leader you can trust.

You can feel confident with IMG knowing our industry expertise has led us to serve millions ofcustomers worldwide since 1990. Owned by SiriusPoint, a multi-billion-dollar insurance industry
leader and rated “A-” by A.M. Best, an independent analyst of the insurance industry, IMG has astrong financial backing and vision to become the preeminent provider of travel and health safety
solutions. With loyal customers ranging from Fortune 500 companies, universities, to individuals
and other insurance companies, our personalized offerings allow us to meet the needs of nearlyanyone traveling internationally.

3

Summary Schedule of Benefits
PLAN DETAILSBRONZESILVER

CarrierGOLD

Sirius Specialty Insurance Corporation

Underwriting approach

Full Medical Underwriting

Period of Coverage

12 months (Annually renewable)

Area of Coverage

Area 2: Worldwide excluding United States, Canada, China, Hong Kong, Japan, Singapore and Taiwan
Area 3: Worldwide

Age

Up to Age 74

Lifetime Maximum
PLAN DETAILSPLATINUM

Deductible

Medical Concierge and International: 50% of the deductible waived up to a
maximum of $2,500.

$1,000,000 per individual$5,000,000 per individual$5,000,000 per individual$8,000,000 per individual$250 to $10,000$250 to $10,000$250 to $25,000$100 to $25,000

Medical Concierge: 100%
U.S. in-network: 100%
U.S. out-of-network: 80% up to $5,000 then 100%
International:100%

Coinsurance

Precertification

Transplants, Interfacility Ambulance Transfer, Medical Evacuation, Orphan Drugs or BIologic Drugs: No coverage if pre-certification requirements are not met
All other Treatments and supplies: 50% reduction of Eligible Medical Expenses if Pre-certification requirements are not met.

Pre-existing Conditions(only applicable when insured is not on a certificate with creditable coverage)

Known Disclosed Conditions

N/A

Covered the same as any illness or
injury unless excluded by a Rider

Covered the same as any illness or
injury unless excluded by a Rider

Covered if disclosed and not
excluded by rider

Non-disclosed Conditions

N/A

No Coverage

No Coverage

Covered if disclosed and not
excluded by rider

N/A

Period of Coverage: $5,000
Lifetime Maximum: $50,000

Period of Coverage: $5,000
Lifetime Maximum: $50,000

Covered if disclosed and not
excluded by rider

Unknown Conditions

After 24 months of continuous coverage

Inpatient

PHYSICAL HEALTH

Subject to Deductible and Coinsurance unless otherwise noted
Eligible Expenses are limited to Usual, Reasonable and Customary amounts
Maximum Limit per Period of Coverage or if indicated, Lifetime Maximum

Eligible Medical Expenses
Physician Visits
Hospitalization Room/Board

Hospital Indemnity(Inpatient hospitalization outside the U.S. only)$600 per day/ 240 day max
Private Hospitals: $400 maximum limit
per overnight and $4,000 maximum
limit per period of coverage
Public Hospitals: $500 maximum limit
per overngiht and $5,000 maximum
limit per period of coverage. Not
subject to deductible or coinsurance

Private Hospitals: $400 maximum limit
per overnight and $4,000 maximum
limit per period of coverage
Public Hospitals: $500 maximum limit
per overngiht and $5,000 maximum
limit per period of coverage. Not
subject to deductible or coinsurance

Private Hospitals: $400 maximum limit
per overnight and $4,000 maximum
limit per period of coverage
Public Hospitals: $500 maximum limit
per overngiht and $5,000 maximum
limit per period of coverage. Not
subject to deductible or coinsurance

Private Hospitals: $400 maximum limit
per overnight and $4,000 maximum
limit per period of coverage
Public Hospitals: $500 maximum limit
per overngiht and $5,000 maximum
limit per period of coverage. Not
subject to deductible or coinsurance

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 Charges are
Usual, Reasonable and Customary and are incurred for Treatment or supplies that are Medically Necessary (“Eligible Medical Expenses”).

4This is a summary schedule of benefits that are subject to exclusions, limitations, maximums, deductible and coinsurance unless otherwise noted. Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way
the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

Summary Schedule of Benefits (Continued)
PLAN DETAILS
Ancillary Services

BRONZESILVERGOLD

PLATINUM

Covered under Hospitalization room &board/professional fees

$400 per day

Covered under Hospitalization room &board/professional fees

Covered under Hospitalization room &board/professional fees

$50 Maximum Limit per visit$50 Maximum Limit per visit$1,000,000 lifetime maximum
Organ procurement and harvesting
costs Lifetime Max: $10,000
Travel & Lodging Lifetime Maximum:$5,000$2,000,000 lifetime maximum
Organ procurement and harvesting
costs Lifetime Max: $20,000
Travel & Lodging Lifetime Maximum:$10,000

Anesthesiologist & Anesthesia
Surgeon & Surgery
Reconstructive Surgery
Assistant Surgeon

20% of primary surgeon’s charges
Maximum consecutive days: 180
Maximum Limit per day: $1500

Intensive Care Unit
Extended Care Facility

Maximum days: 30
Maximum days: 30 (combined with
outpatient)

PHYSICAL HEALTH

HospiceLaboratory
Radiology/X-ray
Physical Therapy
Chemotherapy or Radiation Therapy

Included in Ancillary Services $400 per
day limit

Prescriptions

Transplants$250,000 lifetime maximum
Organ procurement and harvesting
costs Lifetime Max: $10,000
Travel & Lodging Lifetime Maximum:$5,000$250,000 lifetime maximum
Organ procurement and harvesting
costs Lifetime Max: $10,000
Travel & Lodging Lifetime Maximum:$5,000Outpatient Services

Outpatient Services must follow Inpatient Treatment or Outpatient Surgery (Bronze Only)
Subject to Deductible and Coinsurance unless otherwise noted
Eligible Expenses are limited to Usual, Reasonable and Customary amounts
Maximum Limit per Period of Coverage or if indicated, Lifetime Maximum

Eligible Medical Expenses

Maximum Limit: $500 (Prior toInpatient Treatment)

Physician/Specialist Visit

Maximum Limit: $500 (90 days
following Intpatient Treatment or
Outpatient Surgery)

Mental or Nervous disorders available
after 12 months of continuous
coverage
Combined maximum visits: 25
Physician/Specialist maximum per
visit: $70
Chiro max per visit: $50 (with referral
from physician)Surgical Intervention Consultation
max: $500

This is a summary schedule of benefits that are subject to exclusions, limitations, maximums, deductible and coinsurance unless otherwise noted. Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way
the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

5

Summary Schedule of Benefits (Continued)
PLAN DETAILSBRONZESILVER

N/A

N/A

Laboratory

Maximum Limit per visit: $300 (Prior toand post Inpatient Treatment only)

Maximum Limit per visit: $300

Radiology/X-ray

Maximum Limit per examination: $250
(Prior to and post Inpatient Treatment
only)

Maximum Limit per examination: $250

CAT Scans, MRI, Echocardiography, Endoscopy, Gastroscopy,
Cystoscopy

Maximum Limit per examination: $600
(Prior to Inpatient Treatment only)

Maximum Limit per examination: $600

Teleconsultation(Non-Insurance Benefit)

GOLD

PLATINUM

N/A

Available after 10 or 24 months
after Underwriting’s review of theapplication.
Maternity Deductible: $2,500 (Inaddition to plan Deductible)
Lifetime Maximum: $50,000

N/A

Maximum Limit: $250,000
Eligible if the Pregnancy is covered
under the plan
Routine Care during the first 31 daysof life

Hospital Emergency Room: International
Surgery/Outpatient Surgical Facility & Surgeon
Anesthesiologist & Anesthesia
Reconstructive Surgery

20% of primary surgeon’s charges

PHYSICAL HEALTH

Second Surgical Opinion

Chemotherapy or Radiation Therapy
Pre-Admin Testing
Durable Medical Equipment

Maternity

Newborn Care/Congenital Disorders

Newborn Wellness

Podiatry Care
Physical Therapy

Medical order required

Home Nursing Care6

See above

N/A

N/A

N/A

N/A

N/A

N/A

N/A

Maximum Limit: $200
Eligible if the Pregnancy is covered
under the plan
Routine Care after 31 days of life
through 12 months

N/A

N/A

Maximum Limit: $750

Maximum Limit: $750

Available for 90 days following
Inpatient Treatment or Outpatient
Surgery
Maximum Limit per visit: $40
Maximum visits: 10

Maximum Limit per visit: $40
Maximum visits per day: 1
Maximum visits: 30

Maximum Limit per visit: $50
Maximum visits per day: 1
Medical order required

Maximum Limit per visit: $50
Maximum visits per day: 1
Medical order required

Maximum days: 30
Maximum Limit per day: $150

Maximum days: 30

This is a summary schedule of benefits that are subject to exclusions, limitations, maximums, deductible and coinsurance unless otherwise noted. Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way
the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

Summary Schedule of Benefits (Continued)
PLAN DETAILS
Hospice

BRONZESILVER

N/A

Maximum days: 30(combined with Inpatient)GOLD

PLATINUM

Prescription Drugs and Medication

Subject to Deductible and Coinsurance unless otherwise noted
Eligible Expenses are limited to Usual, Reasonable and Customary amounts
Maximum Limit per Period of Coverage or if indicated. Lifetime Maximum

PHYSICAL HEALTH

Prescription Drugs, Dressings, and Durable Medical
Equipment

Expatriate Prescription Services Program

Available for 90 days following
Inpatient Treatment or Outpatient
Surgery
Maximum Limit per event: $600
(Orphan Drugs or Biologic Drugs do
not apply to the Maximum Limit per
event)

N/A

Subject to deductible and coinsurance.
90-day supply per prescription
following related covered event.
U.S. Retail Pharmacy
out-of-network: 80%
International Retail Phamacy: 100%

Subject to deductible and coinsurance.
90-day supply per prescription.
U.S. Retail Pharmacy
out-of-network: 80%
International Retail Phamacy: 100%

N/A

N/A

U.S. Retail Pharmacy:prescription drug card required.
Copay per 30-day supply: $20 for
generic/$40 for brand name wheregeneric is not available.
International Retail Pharmacy(subject to deductible): 100%
Copay per 30-day supply:$20 for generic/$40 for
non-preferred brand name.
Must enroll via provider website: www.
expatps.com
Dispensing maximum: 180 days

Orphan or Biologic Drugs (Available when all conditions are met)

» Approved in writing by company» Medically necessary» Not experimental or investigational

Applies to period of coverage max.
Max limit applies towards lifetime max.

Inpatient Treatment
maximum limit: $250,000.
Outpatient Surgery:up to the maximum limit.
Subject to deductible and coinsurance.
Does not apply to maximum
limit per event

Outpatient and Emergency
Department Treatment
maximum limit: $250,000.
Subject to deductible and coinsurance

Inpatient & Outpatient Treatment
maximum limit: $250,000.
Subject to deductible and coinsurance

Maximum limit $250,000.
U.S. Retail Pharmacy & expatriateprescription services program: Subject tocopayments.
International retail pharmacy: Subject todeductible and coinsurance.
Inpatient/outpatient medical treatment:
Subject to deductible and coinsurance

Preventative CareNOT Subject to Deductible and Coinsurance unless otherwise noted
Eligible Expenses are limited to Usual, Reasonable and Customary amounts
Maximum Limit per Period of Coverage or if indicated. Lifetime MaximumChild Preventative Care
Ages 18 years and younger

Adult Preventative Care

N/A

Maximum Limit per visit: $70
Maximum visits: 3

Maximum Limit: $200

Maximum Limit: $400

N/A

N/A

Maximum Limit: $250

Maximum Limit: $500

This is a summary schedule of benefits that are subject to exclusions, limitations, maximums, deductible and coinsurance unless otherwise noted. Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way
the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

7

Summary Schedule of Benefits (Continued)
PLAN DETAILSBRONZESILVERGOLD

PLATINUM

Vision CareNOT Subject to Deductible and Coinsurance unless otherwise noted
Eligible Expenses are limited to Usual, Reasonable and Customary amounts
Maximum Limit per Period of Coverage or if indicated. Lifetime Maximum

Routine Eye Examination

N/A

N/A

Contact Lenses, Contacts, Frames

N/A

N/A

N/A

Maximum Limit every 24 months: $100

N/A

Maximum Limit every 24 months: $150

Other Services

Subject to Deductible and Coinsurance unless otherwise noted
Eligible Expenses are limited to Usual, Reasonable and Customary amounts
Maximum Limit per Period of Coverage or if indicated. Lifetime Maximum

PHYSICAL HEALTH

Complementary Medicine

Dental Treatment

Traumatic Dental Injury
High School Sports

N/A

N/A

Maximum Limit: $500
Services include Acupuncture,
Aromatherapy, Herbal Therapy,
Magnetic Therapy, Massage Therapy
and Vitamin Therapy

N/A

N/A

Max limit: $100
(Treatment due to unexpected pain tosound natural teeth)
Max limit: $500
(Non-emergency Treatment at a
Dental Provider’s office due to an
Accident)$750 per period of coverage $50
deductible (max. 2 per family)
Routine services-90% (deductible
waived)Minor restorative- 70%
Major restorative- 50%
6 month waiting period

Maximum Limit: $1,000

Maximum Limit: $1,000

N/A

N/A

N/A

Lifetime Maximum: $20,000
Includes Collision Sports

Lifetime Maximum: $250

Lifetime Maximum: $250

Lifetime Maximum: $250

Lifetime Maximum: $250

N/A

N/A

Maximum Limit per Accident: $300

Maximum Limit per Accident: $500

N/A

Healthy Travel Preventative Coverage

Vaccinations and preventative prescription drugs administered by a
Physician within 30 days prior to th eInsured Person’s Initial Effective Dateand before departing to any destination

Supplemental Accident

Optional Coverage
Terrorism

Platinum option only

Sports Rider

Gold and Platinum options

8

N/A

N/A

N/A

N/A

$50,000 lifetime maximum

N/A$10,000 lifetime maximum for amateur
athletics
Adventure Sports:
Through age 49 years: $50,000 lifetime
maximum
Age 50 years through age 59 years:$30,000 lifetime maximum
Age 60 years through age 64 years:$15,000 lifetime maximum$10,000 lifetime maximum for amateur
athletics
Adventure Sports:
Through age 49 years: $50,000 lifetime
maximum
Age 50 years through age 59 years:$30,000 lifetime maximum
Age 60 years through age 64 years:$15,000 lifetime maximumThis is a summary schedule of benefits that are subject to exclusions, limitations, maximums, deductible and coinsurance unless otherwise noted. Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way
the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

Summary Schedule of Benefits (Continued)

MENTAL WELLNESSPLAN DETAILSBRONZESILVERGOLD

PLATINUM

Mental or Nervous Counseling

Subject to Deductible and Coinsurance unless otherwise noted
Eligible Expenses are limited to Usual, Reasonable and Customary amounts
Maximum Limit per Period of Coverage or if indicated. Lifetime Maximum

Mental or Nervous

After 12 months of continuous coverage; no waiting period for Platinum

Bereavement Counseling
Remote Mental Health Service(Non-Insurance Benefit)

N/A

Outpatient after 12 months ofcontinuous coverage

Maximum Limit: $10,000
Lifetime Maximum: $50,000

Lifetime Maximum: $50,000

N/A

Lifetime Max: $300

Lifetime Max: $300

Lifetime Max: $300

N/A

N/A

N/A

DentalDental Rider

PHYSICAL HEALTH

Bronze, Silver and Gold plan options$750 per period of coverage$50 deductible (max. 2 per family)
Routine services-90% (deductible
waived)Minor restorative- 70%
Major restorative- 50%
6 month waiting period$750 per period of coverage$50 deductible (max. 2 per family)
Routine services-90% (deductible
waived)Minor restorative- 70%
Major restorative- 50%
6 month waiting period

Exams-up to $100 per 24 months
Materials-up to $150 per 24 months

Exams-up to $100 per 24 months
Materials-up to $150 per 24 months$750 per period of coverage$50 deductible (max. 2 per family)
Routine services-90% (deductible
waived)Minor restorative- 70%
Major restorative- 50%
6 month waiting period

Dental Treatment benefit alreadyincluded; no rider required

VisionVision Rider

Bronze, Silver and Gold plan options

Exams-up to $100 per 24 months
Materials-up to $150 per 24 months

Vision Care benefit already included;
no rider required

Services

Universal Rx Drug Card Copayments

N/A

N/A

N/A

Generic: $20
Brand: (when Generic is unavailable):$40
Copayments are per 30-day supply
Dispensing maximum per prescription:
90 days

The Family Matters Program

N/A

N/A

N/A

Provides educational information on
pregnancy and provides suggestions
for a healthy lifestyle

CRISIS SUPPORTEmergency Services

NOT Subject to Deductible and Coinsurance unless otherwise noted
Eligible Expenses are limited to Usual, Reasonable and Customary amounts
Maximum Limit per Period of Coverage or if indicated. Lifetime Maximum

Emergency Local Ambulance

Injury/Illness resulting in an Inpatient Hospital admission

Emergency Medical Evacuation
Emergency Reunion

Maximum Limit per incident: $1,500

Maximum Limit per incident: $1,500

Maximum Limit: $50,000

Maximum Limit: $50,000

Up to the Lifetime Maximum

Up to the Lifetime Maximum

Lifetime Maximum: $10,000
Maximum days: 15
Meal Maximum Limit per day: $25

N/A

Lifetime Maximum: $10,000
Maximum days: 15
Meal Maximum Limit per day: $25

Lifetime Maximum: $10,000
Maximum days: 15
Meal Maximum Limit per day: $25

This is a summary schedule of benefits that are subject to exclusions, limitations, maximums, deductible and coinsurance unless otherwise noted. Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way
the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

9

Summary Schedule of Benefits (Continued)
PLAN DETAILSBRONZESILVER

Maximum Limit per incident: $1,500

Maximum Limit per incident: $1,500

Political Evacuation and Repatriation

N/A

Remote Transportation
Return of Mortal Remains

CRISIS SUPPORTInterfacility Ambulance Transfer(United States Only)GOLD

PLATINUM

N/A

N/A

Lifetime Maximum: $10,000

N/A

N/A

N/A

Maximum Limit: $5,000
Lifetime Maximum: $20,000

Maximum Limit: $25,000

Maximum Limit: $25,000

Maximum Limit: $25,000

Maximum Limit: $50,000

N/A

Emergency travel assistance services$5,000$75,000$50,000$35,000$25,000$20,000$15,000$10,000$7,500$5,000$75,000$50,000$35,000$25,000$20,000$15,000$10,000$7,500Services
Global Concierge

N/A

N/A

Travel Intelligence App

Optional Coverage
FINANCIAL PROTECTION

Global Term Life Insurance
Age 31 days -18 years
Age 19-29 years
Age 30-39 years
Age 40-44 years
Age 45-49 years
Age 50-54 years
Age 55-59 years
Age 60-64 years
Age 65-69 years

AD&D

PERSONAL
PROPERTY

included with Term Life

Mobile Device Protection Rider$5,000$75,000$50,000$35,000$25,000$20,000$15,000$10,000$7,500$5,000$75,000$50,000$35,000$25,000$20,000$15,000$10,000$7,500

Accidental Loss of Life: Principal Sum*
Accidental Total Loss of 2 Members**: Principal Sum*
Accidental Total Loss of 1 Member**: 50%*(*Benefit based on age at time of death** “Member” means hand, foot or eye)

Coverage for repair or replacement of your cell phone if it is lost, stolen, or accidentally damaged during your trip.

M y I M G SM M e m b e r P o r t a l
It’s easy to access and manage your IMG accounts any time, from anywhere and any device, via MyIMG.
MyIMG features include:» Claims submission and management» ID Card and insurance documents access» Precertification process initiation
10» Explanation of Benefit (EOB) access» Customer Care live chat and contact information» Find a Doctor locator

This is a summary schedule of benefits that are subject to exclusions, limitations, maximums, deductible and coinsurance unless otherwise noted. Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way
the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

Increase the cover available with your Global Medical Insurance plan by considering these options.

T e r r o r i s m (Platinum only)
Normally a standard policy exclusion, this optional add-on will now cover you for
up to $50,000 should you find yourself the victim of terrorist activities and needto make a claim as a direct result of them.

For you and your family to get the most out of your stay overseas you can
include our special sports rider. This will not only include a comprehensive listof adventure sports (normally excluded by insurers), providing benefits of up to$50,000, but now has additional coverage for amateur athletics up to $10,000.
D e n t a l & V i s i o n R i d e r (Bronze, Silver & Gold)T E R M L I F E I N S U R A N C E P L U S A D & D (All plan levels)
For maximum coverage you can now include Term Life and Accidental Death andDisability benefits to your policy, with payments of up to $75,000 if you or yourfamily need to make a claim as the direct result of a death or serious accident anddisability.
M o b i l e D e v i c e P r o t e c t i o n (All plan levels)

S P O R T S R I D E R (Gold & Platinum)
PERSONAL
PROPERTY

PHYSICAL HEALTH

Rider option is available on individual plans only.

FINANCIALPROTECTION

Additional Optional Coverage

Cell phones are essential when travelling internationally to keep you safe, connect
with friends and family back home, and to take photos of your travels. Device
protection provides coverage for repair or replacement of your cell phone when
it becomes lost, stolen, or accidentally damaged. With Mobile Device Protection,
you can continue your travels and stay digitally connected wherever you are in
the world.

Our Global Medical Insurance plan already provides some dental and vision
benefits for people on Gold and Platinum levels of cover, but this rider now allows
all policyholders to include coverage for routine services, restorative treatments,
exams and materials. This add-on is available for the whole family. Customers on
our Platinum level will enjoy these benefits as standard.

This is a summary schedule of benefits that are subject to exclusions, limitations, maximums, deductible and coinsurance unless otherwise noted. Benefits are subject to exclusions and limitations. This is only a summary and does not supersede in any way
the Certificate of Insurance and governing policy documents (together the “Insurance Contract”). The Insurance Contract is the only source of the actual benefits provided.

11

BRONZE

A vital companion that provides access to dynamic alerts and country intelligence
to help you prepare for and stay safe while away from home.

Whether you are seeking care at a local facility or in an unfamiliar location, qualityof care is a primary concern. IMG’s Medical Concierge program (available in theU.S.) is designed to provide you with critical information and to assist you in
making the right decision for treatment. Your personal Medical Concierge will
review your specific non-emergency medical condition and provide you withinformation on provider ratings, past outcomes, and general costs—all in thearea where you are planning treatment.

PHYSICALHEALTH

You will be entitled to receive a reduction in your deductible for utilizing thisunique medical service while in the United States. This level of individualized
service is unmatched in the international arena.

PLATINUM

M e d i c a l C o n c i e r g e (All plan levels)» Travel Intelligence - Trustworthy and timely intelligence, professional advice
and support» Safety Alerts - Alert notifications of high-risk events, including health, terrorism,
civil unrest, severe weather risks, in or near your current location» Travel Essentials - Emergency hotline, access to travel documents, importantitinerary information» Location Awareness - View and receive notifications of proximity threats basedon your current and last shared location» Destination/Location Tips - Advice based on travel itinerary or countries ofinterest» Friends and Family Sharing - Add additional users to your account so they canbe notified in case of an emergency or a potential threat

T e l e c o n s u l t a t i o n * (Gold & Platinum)
Online and telephonic access to a network of medical professionals available
to diagnose, treat and prescribe for non-emergency medical issues. The best
medicine brought to you and your family 24 hours a day, seven days a week.

*Teleconsultations will not support a diagnosis for Mental or Nervous Disorders. Coverage for a Teleconsultation is not a determination that any specific condition discussed, raised
or identified during such Consultation is covered under this insurance. We reserve the right to decline future claims relating to or arising from any condition discussed, raised or
identified during a Teleconsultation where the illness or injury is directly or indirectly related to any Pre-existing Condition or is otherwise excluded under this Policy.

SILVERT r a v e l I n t e l l i g e n c e (All plan levels)

This discount savings program allows you to purchase prescriptions at one ofover 35,000 participating pharmacies in the U.S. and receive the lower of 1)
Universal Rx contract price or 2) the pharmacy regular retail price. This program
is not insurance coverage. It is purely a discount program.

GOLD

U n i v e r s a l R X P h a r m a c y D i s c o u n t S a v i n g s (All plan levels)

CRISIS SUPPORTFINANCIAL PROTECTION

Available with Select GMI Plans

12

GLOBAL MEDICAL INSURANCE®
A WORLDWIDE MEDICAL INSURANCEP R O G R A M F O R I N D I V I D U A L S , A N D F A M I L I E S.

13

The Family Matters® Maternity Program

Travel Assistance Services

This program is designed to provide you with educational information on
your pregnancy and suggestions for a healthy lifestyle for the expecting mom
and family. A complimentary copy of the book “What to Expect When You’re
Expecting” is provided to help answer the day-to-day questions faced by all
expectant families. This program can also assist you in early detection of potential
pregnancy complications and encourages proper prenatal medical treatment.

You also have exclusive access to a list of additional emergency travel assistanceservices handled by a dedicated service team available 24/7. Some of theassistance services provided include:

eDocAmerica
Receive direct access to eDocAmerica, a worldwide medical information service,
which allows you to communicate with licensed physicians, psychologists,
pharmacists, dentists, dieticians, and fitness trainers free of charge, 24 hours a day.
eDocAmerica’s services result in saved office visits, peace of mind, confidence toact, and ultimately, an informed, empowered member.

CRISIS SUPPORTPHYSICAL HEALTH

PLATINUM BENEFITS & SERVICES» Emergency travel arrangements» Lost passport/travel documents
assistance» Lost luggage assistance» Embassy or consulate referrals» Emergency message relay» Emergency prescription
replacement» Medical referrals» 24-hour medical monitoring» Emergency cash transfer andemergency translations» Legal referrals

MENTALWELLNESS

Remote Mental Health Services
Telemedicine for mental health that supports with financial, physical andemotional wellbeing. Whether you have questions about handling stress at workor home, parenting and childcare, managing money or health issues, you canturn to this valuable and confidential service that you can trust.

14

Global Medical Insurance®

Lifetime Coverage

Global Medical Insurance is available to individuals and families of all nationalities. U.S.
citizens must plan to be residing outside the U.S. on or before their effective renewal
dates, and for at least six (6) out of the next 12 months. Additional eligibility restrictions
apply to non-U.S. citizens residing in the United States. Persons from the ages of 14 days
to 74 years may apply for coverage, up until the age of 75. Persons 75 years of age andolder are not eligible for coverage. Please see a sample contract for further details.

Lifetime medical coverage is available if you are enrolled in the Global Medical Insurance
program by your 65th birthday and maintain continuous coverage to age 75. Prior toyour 75th birthday, you will receive a summary of benefits for the Global Senior Plan®
and an enrollment form for coverage. There is no additional medical underwriting. You
simply need to review the benefits, and promptly complete and return the enrollment
form with your premium.

Enrollment

Quality Guarantee

To apply for Global Medical Insurance, simply complete the online application. If you are
applying as a family, you may include yourself, your spouse, and your dependents on
one application. If you have dependents who are age 19 and older, you must complete
a separate application for those individuals. You must accurately complete all questions
outlined in the application in order to be considered for coverage.

To ensure your satisfaction, once you are accepted in the plan, we provide a 15-day
free look period to review the coverage. If, during that 15-day period, you find that you
are not satisfied with the plan for any reason, you may submit a written request forcancellation and a full refund of your premium received by IMG. See the Certificate
Wording for full details.
IMPORTANT NOTICE REGARDING PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA):This insurance is not subject to, and does not provide benefits required by PPACA. Since January 1, 2014, PPACA requires U.S. citizens,
U.S. nationals and certain U.S. residents to obtain PPACA compliant insurance coverage unless they are exempt from PPACA. Penalties
may be imposed on persons who are required to maintain PPACA compliant coverage but do not do so. Eligibility to purchase, extend
or renew this product, or its terms and conditions, may be modified or amended based upon changes to applicable law, including
PPACA. Please note that it is an insured person’s sole and exclusive responsibility to determine the insurance requirements applicableto them, and the Company and IMG shall have no liability whatsoever, including for any penalties a person may incur, for failure toobtain coverage required by any applicable law including without limitation PPACA. For information on whether PPACA applies toyou or whether you are eligible to purchase Global Medical Insurance, please see IMG’s Frequently Asked Questions at imglobal.com/
en/client-resources/PPACA-FAQ.aspx.

GOLD

If approved, you will receive an online fulfillment kit, which includes a digital
identification card, declaration of insurance, and a Certificate Wording containing acomplete description of benefits, exclusions, and terms of the plan. You are required to
notify IMG, as required by the terms of the plan, if you or any family member suffers fromor is treated for any illness, injury, or other medical condition between the time of yourapplication and the issuance of the certificate. If your application is not approved, youwill receive a full refund of any premium received by IMG. For additional ­information,please contact your independent insurance producer.

SILVER

Eligibility

BRONZE

Coverage you can count on, with 24/7 service anywhere in the world

IMG has a history of understanding its customers as well as delivering insurance products thatmeet their specific needs, so in addition to being available to individuals and families Global
Medical Insurance will appeal to those working as parts of organizations, churches, social good
programs, and non-governmental organizations sending volunteers, workers, and missionaries
abroad. We’re also pleased to make Global Medical Insurance available to professional marinecrew members to protect their health while at sea and in port.

Global Medical Insurance®

15

PLATINUM

Missionary and Marine Crew

WORRY LESS. EXPERIENCE MORE.

International Medical Group® (IMG®)
Telephone: +1.317.655.4500
Fax: +1.317.655.4505
Email: insurance@imglobal.com

Producer Contact Information
HIRANO - HOLCOMB INSURANCE AGENCY, LLC
P.O. BOX 12580
MILL CREEK, WA 98082
Phone: 206-755-5585
Fax: 888-391-5155
masako@mhhinsurance.com
http://www.mhhinsurance.com

This invitation to inquire allows eligible applicants an opportunity to seek information about the insurance offered and is limited to a brief description of any loss for which
benefits may be payable. Benefits are offered as described in the insurance contract. Benefits are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations,and exclusions in the insurance contract.
Certain contracts do contain a pre-existing condition exclusion and do not cover losses or expenses related to a pre-existing condition.
This brochure contains many of the valuable trademarks, names, titles, logos, images, designs, copyrights and other proprietary materials owned and registered and used by ofInternational Medical Group, Inc. and its representatives throughout the world. © 2007-2024 International Medical Group, Inc. All rights reserved.
Capitalized terms are defined in the Certificate of Insurance.

CM0050A2223231120

0124