The Nutmeg Global Plan is for the students, faculty, staff, chaperones and their dependents who are traveling internationally outside of the United States on school sponsored trips. The Plan is limited to the Connecticut schools which comprise the Nutmeg Group. The Plan is a group program and is for all students involved in the international trip.
Plan Highlights: Accident and Sickness Insurance up to $1,000,000 per condition, no deductible, 100% of Covered Expenses.
Covered Expenses include:
1. Expenses made by a hospital for room and board, general nursing and other services inclusive of charges for professional service and with the exception of personal services of a non-medical nature, provided, however, that expenses do not exceed the hospital’s average charge for semi-private room and board accommodation.
2. Expenses made for diagnosis, treatment and surgery by a doctor.
3. Expenses made for the cost and administration of anesthetics.
4. Expenses for x-ray services, laboratory tests, medical services and supplies (includes blood and blood transfusion, oxygen and its administration).
5. Expenses for physiotherapy, if recommended by a doctor for the treatment of an Injury or Sickness, and administered by a licensed physiotherapist. Chiropractic care is limited to 80% of eligible charges up to $35 per visit and a maximum of 10 visits per Injury or Sickness. Physiotherapy is limited to 20 days per policy year.
6. Expenses for treatment of mental and nervous disorders. Benefits are payable: a) up to a $300 maximum for outpatient treatment, and b) 50% of covered expenses for inpatient treatment up to a maximum of 10 days.
7. Expenses for prescription drugs including dressings, drugs and medicines prescribed by a doctor.
8. Dental expenses resulting from an accident and dental expenses for emergency pain relief treatment to sound, natural teeth: limit $100 per tooth, $500 overall maximum limit. Emergency Medical Evacuation Benefit: The Company will pay Emergency Medical Evacuation Benefits for 100% of Covered Expenses incurred for the medical evacuation of a Covered Person. Benefits are payable if the Covered Person: 1) suffers a Medical Emergency during the course of the Trip; 2) requires Emergency Medical Evacuation; and 3) is traveling outside of his or her Home Country. Covered Expenses:
1. Medical Transport: expenses for transportation under medical supervision to a different hospital, treatment facility or to the Covered Person’s place of residence for Medically Necessary treatment in the event of the Covered Person’s Medical Emergency and upon the request of the Doctor designated by Our assistance provider in consultation with the local attending Doctor.
2. Dispatch of a Doctor or Specialist: the Doctor’s or specialist’s travel expenses and the medical services provided on location, if, based on the information available, a Covered Person’s condition cannot be adequately assessed to evaluate the need for transport or evacuation and a doctor or specialist is dispatched by Our service provider to the Covered Person’s location to make the assessment.
3. Return of Dependent Child(ren): expenses to return each Dependent child who is under age 18 to his or her principal residence if a) the Covered Person is age 18 or older; and b) the Covered Person is the only person traveling with the minor Dependent child(ren); and c) the Covered Person suffers a Medical Emergency and must be confined in a Hospital.
4. Escort Services: expenses for an Immediate Family Member or companion who is traveling with the Covered Person to join the Covered Person during the Covered Person’s emergency medical evacuation to a different hospital, treatment facility or the Covered Person’s place of residence. Benefits for these Covered Expenses will not be payable unless: 1) the Doctor ordering the Emergency Medical Evacuation certifies the severity of the Covered Person’s Medical Emergency requires an Emergency Medical Evacuation; 2) all transportation arrangements made for the Emergency Medical Evacuation are by the most direct and economical conveyance and route possible; 3) the charges incurred are Medically Necessary and do not exceed the Covered Expenses for similar transportation, treatment, services or supplies in the locality where the expense is incurred; and 4) do not include charges that would not have been made if there were no insurance. During the course of an Emergency Medical Evacuation of a covered person to their Home Country, all benefits under this plan are terminated except Accidental Death and Dismemberment Benefits. “Medical Emergency” means a condition caused by an Injury or Sickness that manifests itself by symptoms of sufficient severity that a prudent lay person possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would place the health of the person in serious jeopardy. “Trip” means travel by air, land, or sea from the Covered Person’s Home Country. Benefits will not be payable unless the Company, or MEDEX authorizes in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by MEDEX. Emergency Reunion Benefit: In the event of an Emergency Medical Evacuation due to a covered Injury or Sickness, where the doctor feels it would be beneficial for the covered person to have a family member at his or her side during transport, the Company will pay the expenses incurred for travel and lodging for that relative, up to a maximum of $12,500. Covered Expenses include an economy airline ticket and other travel related expenses not to exceed $300 a day for a maximum of ten days. Benefits will not be payable unless the Company, or MEDEX authorizes in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by MEDEX. Repatriation of Remains Benefit: The Company will pay Repatriation Benefits of 100% of Covered Expenses for preparation and return of a Covered Person’s body to his or her home if he or she dies as a result of a Medical Emergency while traveling outside of his or her Home Country. Covered expenses include: 1) expenses for embalming or cremation; 2) the least costly coffin or receptacle adequate for transporting the remains; 3) transporting the remains; and 4) Escort Services: expenses for an Immediate Family Member or companion who is traveling with the Covered Person to join the Covered Person’s body during the repatriation to the Covered Person’s place of residence. All transportation arrangements must be made by the most direct and economical route and conveyance possible and may not exceed the Covered Expenses for similar transportation in the locality where the expense is incurred. Benefits will not be payable unless the Company, or MEDEX authorizes in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by MEDEX. Accidental Death and Dismemberment, $20,000 Principal Sum, $500,000 Aggregate Limitation. For a copy of plan description including benefits, limitations and exclusions click here. Enrollment Information: Premium Rates: Class 1 Student $18.00 per week
Class 2 Faculty, Staff, Chaparones $36.50 per week
Class 3 Dependent Spouses or Children (to age 19) $41.50 per week Enrollment is sent to CMI Insurance on roster forms via email. Click here for the roster in excel format.
Download the roster and email to CMI along with your contact information. After CMI and the responsible person at the Nutmeg participating school make contact and agree to coverage details, enrollment process, and pricing, CMI will invoice for payment and arrange for issuing coverage. Please make sure to identify yourself as part of the Nutmeg program when you contact us. This is a group mandatory plan with coverage provided for all students involved in the international trip. Faculty, staff, chaparones and dependents are also eligible for coverage. We must have names, dates of birth, coverage dates, gender and destinations. We will provide coverage confirmations back to the person submitting the data. Please call us with any questions, our contact information is listed in the Contact Us section at the top of this page. This Plan is arranged and marketed by Fred C. Church Insurance of Lowell, MA in partnership with CMI Insurance. CMI specializes in international educational insurance products. The Plan is insured by ACE American Insurance Company, rated A+ Excellent by A. M. Best & Company. Assistance features are provided by MEDEX Assistance (see tab at top to the left). Claims are administered by Administrative Concepts, Inc. (see tab at top to the left).
|
