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Americas Europe Middle East AsiaPAC 1 Medical Benefits Abroad German American Chamber of Commerce (GACC ) Policy # 05958A INTERN HEALTH INSURANCE PLAN Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
MBA Program – Overview 2 Provides coverage for unexpected injuries and illnesses that may occur while traveling to the United States for the purpose of an internship Claims are paid as a first payor and supplement your domestic or national plan. Multilingual Customer Service Representatives are available 24 hours a day, 7 days a week, 365 days a year Nearly 100% success rate in establishing guarantees of payment to doctors and hospitals Quick claims reimbursements in nearly 100 currencies Coverage while vacationing outside of the host country (7 Days maximum) Coverage for Emergency Medical Assistance Dedicated website for international travelers Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
MBA Program – Eligible Customers 3 All non-U.S. interns who are traveling to the U.S. solely on the business of the Policyholders affiliates, outside their country of residence or permanent assignment. Persons for whom coverage is prohibited under applicable law or who are not covered by comprehensive medical insurance which complies with legal and regulatory requirements in their home country will not be considered eligible for this plan. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
MBA Program – INTERN Materials 4 Welcome Kits will include: Certificate of Insurance Cigna MBA ID card Concierge and Travel Assistance Services Flyer MBA Claim Form Plan Sponsor Verification Form Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
MBA Program – FAQ 5 What type of coverage does the MBA policy provide? The MBA policy providers coverage for any injury, illness, or emergency medical assistance during the internship in the U.S. It also provides coverage for prescriptions resulting from an accident or illness. How do interns enroll for the program? All insured interns prior to 3/1/2013 will automatically be eligible for the plan benefits. Anyone enrolling after 3/1/2013 will be required to complete a “Plan Eligibility Form”. How do interns submit a claim? Interns may either submit their initial claim through mail, fax or email; if the Intern chooses they may assign payment directly to the CIGNA doctor or hospital and avoid any “Out of Pocket” costs Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
MBA Program – FAQ 6 What types of payment options are available? Interns can receive payment either by check, direct deposit, or EFT to a U.S. bank account. In addition, payment may be assigned directly to a CIGNA provider, avoiding the need for reimbursement. Wire transfer is another option but is suggested for large claims since there are usually lifting fees that would be the intern’s responsibility. The payment options are listed on the MBA claim form. (visit www.Cigna.com to access PPO Providers)www.Cigna.com Does the MBA policy provide any additional services? The MBA policy provides Concierge Services that include many benefits such as assistance with lost luggage, translation services, and legal referrals among others. What is covered under medical evacuation and repatriation? Under Evacuation, Cigna will pay up to the sum listed in the Certificate of Coverage to transport the intern to the nearest health care facility able to handle the situation. This benefit also includes economy class transportation charges for the return of the employee from the treatment facility to his or her home, as long as the charges are incurred within one year from the date the member was scheduled to return from the internship. Under Repatriation, Cigna will pay up to the sum under the schedule of benefits for the return of the employee’s mortal remains to his or her permanent address. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
MBA Program – Covered Expenses 7 Examples of Covered Expenses at 100% (NO COPAYS OR DEDUCTIBLES)*: Medical, surgical care, and treatment provided by a physician as a result of an accident or sickness. Emergency Dental, includes dental accident to a sound natural tooth and alleviation of sudden unexpected dental pain subject to policy maximums Hospital room and board charges and intensive care unit charges, subject to policy maximums. All medically necessary and/or required surgical services and supplies while confined in a hospital. Outpatient medical care expenses provided by hospital or clinic. Professional local ambulance service. * This list contains examples and is not all-inclusive. MBA customers should refer to their MBA certificate/policy for a complete listing and information on coverage, limitations, and exclusions. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
MBA Program – Non Covered Expenses 8 Examples of Non Covered Expenses*: Routine physical exams, unless required because of sickness. Expenses related to alcoholism, chemical dependency, or drug addiction. Cosmetic or Plastic Surgery. Injury as a result of commission of felony Any Care received in the Intern’s Country of Origin * This list contains examples and is not all-inclusive. MBA customers should refer to their MBA policy for a complete listing and information on coverage, limitations, and exclusions. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Claim Submission Options 9 Interns submit their initial claim through fax, mail/courier, or email. If utilizing a CIGNA provider, the benefits may be assigned directly to that provider, with no Out of Pocket expense to the intern. Courier Delivery Cigna Global Health Benefits 300 Bellevue Parkway Wilmington, Delaware USA 19850-5111 Mail Delivery Cigna Global Health Benefits P.O. Box 15111 Wilmington, Delaware USA 19850-5111 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Cigna Contact Numbers 10 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Americas Europe Middle East AsiaPAC On behalf of the GACC: Cigna wishes you a safe and healthy assignment
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