ExchangeGuard Choice has 6 months waiting period for pre-existing conditions.
ExchangeGuard Essential has 12 months waiting period for pre-existing conditions.
The ExchangeGuard plan is with you as you travel outside of your home country for the purpose of studying, researching, teaching, or participating in a cultural exchange program in the United States.
Why Choose ExchangeGuard?
Whatever your reason, international travel should be a pleasant experience. Complications and emergencies such as illness, injury, and natural disasters are a fact of life. While we hope none of these incidents happen, we're here to help if they do.
ExchangeGuard helps you manage unexpected medical costs while traveling abroad. Benefits include coverage for inpatient and outpatient medical expenses, $1,000,000 of coverage for emergency medical evacuation, coverage for lost checked baggage, and many other important benefits.
Do I need travel medical insurance?
Many times, the primary medical insurance in your home country will not cover you while traveling abroad. It often will not provide important services in the event of an illness or injury. ExchangeGuard provides coverage for eligible medical expenses and emergency travel benefits in addition to key services such as translation assistance during treatment, doctor and hospital referrals, and assistance replacing lost prescriptions.
After purchasing coverage, how can I trust the company to be there if I need them?
The administrator, headquartered in the United States in Carmel, Indiana, is a full-service company offering international medical insurance designed to meet needs of consumers worldwide.
The administrator is a member of the Tokio Marine HCC group of companies. Tokio Marine HCC is a leading specialty insurance group conducting business in approximately 180 countries and underwriting more than 100 classes of specialty insurance. Headquartered in Houston, Texas, the company is made up of highly entrepreneurial teams equipped to underwrite special situations, companies and individuals, acting independently to deliver effective solutions. Our products and capabilities set the standard for the industry, and many of our nearly 3,000 employees are industry-leading experts. Tokio Marine HCC is part of Tokio Marine, a premier global company with a market cap of approximately $30 billion.*
*As of 12/08/22
ExchangeGuard Schedule of Benefits and Limits
| Plan Details | |
|---|---|
| Lifetime Maximum Limit | $5,000,000 |
| Maximum Limit Per Injury/Illness | $100,000, $250,000, or $500,000 |
| Deductibles | $0, $250, or $500 per certificate period, or $100 per injury/illness |
| Coinsurance - Claims incurred in U.S. | Within the PPO: 80/20: We will pay 80% of eligible expenses after the deductible up to the maximum limit per injury/illness; or 100%: We will pay 100% of eligible expenses after the deductible up to the maximum limit per injury/illness. Outside the PPO: Usual, reasonable, and customary. You may be responsible for any charges exceeding the payable amount. |
| Coinsurance - Claims incurred outside U.S. | We will pay 100% of eligible expenses after the deductible up to the maximum limit per injury/illness. |
| Eligible expenses are subject to deductible, coinsurance, and are per certificate period unless specifically indicated otherwise. | |
| Benefit | Limit |
| Hospital Room and Board | Average semi-private room rate, including nursing services. |
| Local Ambulance | Usual, reasonable, and customary charges for covered illness or injury. Illness must result in hospitalization as inpatient. |
| Intensive Care Unit | Up to the maximum limit per injury/illness. |
| Emergency Room Co-payment | Claims incurred in the U.S. The member shall be responsible for a $250 co-payment for the emergency room facility fee for each use of emergency room for an illness unless the member is admitted to the hospital. There will be no copayment for emergency room treatment of an injury. Claims incurred outside the U.S. No co-payment |
| Urgent Care Center Co-payment | Claims incurred in the U.S. For each visit, the member shall be responsible for a $15 co-payment, after which coinsurance will apply. - Co-payment is waived for members with a $0 deductible. - Not subject to deductible. Claims incurred outside the U.S. No co-payment |
| Hospital Indemnity (in addition to medical expenses) | $100 per day of inpatient hospitalization for member's use to offset miscellaneous expenses (not subject to deductible or coinsurance). |
| Outpatient Physical Therapy and Chiropractic Care | Up to $500 maximum (not subject to coinsurance) |
| Pre-existing Conditions | For conditions existing within 2 years before the effective date, charges are excluded until after 6 months of coverage for ExchangeGuard Choice or after 12 months of coverage for ExchangeGuard Essential, and a $500 maximum applies per certificate period. |
| Terrorism | Up to $50,000 maximum lifetime limit, eligible medical expenses only. |
| Emergency Dental | Up to $300 (not subject to deductible or coinsurance). |
| Emergency Eye Exam Copayment | Up to $150. $50 copayment per occurrence (plan deductible is waived). - not subject to coinsurance |
| All Other Eligible Medical Expenses | Up to the maximum limit per injury/illness. |
| Emergency Travel Benefits | Limit |
| Emergency Medical Evacuation | Up to $1,000,000 lifetime maximum (not subject to deductible or coinsurance). |
| Return of Minor Children | Up to $50,000 (not subject to deductible or coinsurance). |
| Pet Return | Up to $1,000 (not subject to deductible or coinsurance). |
| Repatriation of Remains | Equal to the elected overall maximum limit per injury/illness (not subject to deductible or coinsurance). This limit is for this benefit only and is not included in or subject to the maximum limit per injury/illness. |
| Emergency Reunion | Up to $100,000, subject to a maximum of 15 days (not subject to deductible or coinsurance). |
| Natural Disaster - Replacement Accommodations | Up to $250 per day for 5 days (not subject to deductible or coinsurance). |
| Trip Interruption | Up to $10,000 (not subject to deductible or coinsurance). |
| Trip Delay | Up to $100 per day after a 12-hour delay requiring an unplanned overnight stay (2 days maximum) (not subject to deductible or coinsurance). |
| Lost Checked Luggage | Up to $1,000 (not subject to deductible or coinsurance). |
| Lost or Stolen Passport/Travel Visa | Up to $100 (not subject to deductible). |
| Political Evacuation | Up to $100,000 lifetime maximum (not subject to deductible or coinsurance). |
| Accidental Death and Dismemberment (excludes loss due to common carrier accident) | $250,000 maximum benefit per one family or group. (Not subject to deductible or coinsurance.) |
| Members up to age 18 | Lifetime max. - $5,000; Death - $5,000; Loss of 2 limbs - $5,000; Loss of 1 limb - $2,500. |
| Members age 18 through 64 | Lifetime max. - $25,000; Death - $25,000; Loss of 2 limbs - $25,000; Loss of 1 limb - $25,000. |
| Common Carrier Accidental Death | Up to age 18 - $10,000 per member; Age 18 to 64 - $50,000 per member; $250,000 maximum benefit per one family or group. (Not subject to deductible or coinsurance.) |
| Crisis Response | Up to $10,000 (not subject to deductible or coinsurance.) |
| Personal Liability | Lifetime maximum - $25,000 Third person injury - Up to $25,000 Third person property - Up to $25,000 Related third person property - Up to $2,500 (not subject to deductible or coinsurance) |
| Bedside Visit | Up to $1,500 (not subject to deductible or coinsurance). |
What's Covered by ExchangeGuard?
International Coverage
Emergency Medical Evacuation and Emergency Reunion
Would you know what to do if you found yourself in a life-threatening situation far from home? We are experienced in arranging emergency medical evacuations. ExchangeGuard will cover eligible expenses necessary to transport you from an initial treating facility to the nearest hospital qualified to treat your life-threatening condition. We also understand the importance of family support in these difficult situations. ExchangeGuard will also cover the transportation, lodging, and meal costs for a relative to join you after a covered emergency medical evacuation, up to the lifetime limit.
Repatriation of Remains
What would your family do if disaster strikes while you are away from home? The death of a loved one is never easy, no matter the circumstances. In the unfortunate event of your death while traveling abroad, ExchangeGuard will arrange for and cover the costs associated with the repatriation of your remains.
Return of Minor Children
If you are expected to be hospitalized for more than 36 hours due to a covered injury or illness and covered children under 18 years of age will be left unattended as a result, ExchangeGuard will cover the transportation cost for the children to return home.
Terrorism
In these turbulent times, the risk of a terrorist attack is a reality. If you are in the wrong place at the wrong time, and the country or region you're visiting is NOT under a level 3 or higher travel advisory, ExchangeGuard offers coverage for eligible medical expenses resulting from those acts. Coverage excludes countries or regions for which the U.S. Department of State has issued a level 3 ("reconsider travel") or higher travel advisory in the 60 days prior to your arrival date.
Political Evacuation
If, during the coverage period and after your arrival, the U.S. Department of State issues a level 3 or higher travel advisory for your destination country, ExchangeGuard will coordinate your alternate departure arrangements from that country and cover eligible associated costs.
Natural Disaster Benefit
Natural disasters can happen anywhere and at any time. If a natural disaster occurs on your trip, causing you to become displaced from your planned and paid accommodations, ExchangeGuard will provide relief of a maximum of $250 a day for 5 days to help cover the costs of alternative accommodations.
ExchangeGuard* Quality Benefits
Pre-Existing Conditions
For conditions existing within 2 years before the effective date, charges are excluded until after 6 months of coverage for ExchangeGuard Choice or after 12 months of coverage for ExchangeGuard Essential, and a $500 maximum applies per certificate period.
Pre-existing condition means any injury, illness, sickness, disease, or other physical, medical, mental, or nervous disorder, condition, or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the 2 years prior to the effective date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, treated, or disclosed to us prior to the effective date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising therefrom.
Hospitalization and Outpatient Treatment
If a covered illness or injury requires hospitalization, the plan provides coverage for costs associated with hospitalization, including intensive care unit and outpatient treatment.
Sports Coverage
ExchangeGuard includes coverage for eligible injuries and illnesses that could occur while participating in many popular vacation sports - skiing and snowboarding (recreational downhill and/or cross country), snorkeling, water skiing, and others - at no additional cost. Certain extreme sports are excluded from coverage.
Complications of Pregnancy
ExchangeGuard offers coverage for complications of pregnancy during the first 26 weeks of gestation.
Crisis Response
ExchangeGuard offers up to $10,000 to offset costs associated with kidnapping, such as ransom, crisis response expenses, and loss of personal belongings. This benefit includes access to the services of Unity Advisory Group / On Call International for advice, coordination with law enforcement, and negotiations during a kidnapping.
Personal Liability
ExchangeGuard offers up to $25,000 to offset the following types of court-entered eligible judgments or approved settlements incurred by the member.
- Third-party injury;
- Damage/loss of a third party's personal property;
- Damage/loss of a related third party's personal property.
*The description of coverage in these pages is for informational purposes only. Actual coverage will vary based the terms and conditions of the policy issued. The information described herein does not amend or otherwise affect the terms and conditions of any insurance policy issued by the administrator or its affiliates. In the event that a policy is inconsistent with the information described herein, the language of the policy will take precedence.
Enrollment and Filing a Claim
Home Country Coverage
Incidental Home Country Coverage
You must have purchased three months of coverage for the Incidental Home Country Coverage to be in effect.
For individuals with U.S. as home country, for every three-month period during which the member is covered hereunder, medical expenses incurred in the U.S. are covered up to a maximum of 15 days.
For individuals with a home country other than the U.S., for every three-month period during which the member is covered hereunder, medical expenses incurred in the member’s home country are covered up to a maximum of 30 days.
Any benefit accrued under a single three-month period does not accumulate to another period. Failure of the member to continue his or her international trip or the member returning to their home country for the sole purpose of obtaining treatment for an illness or injury that began while traveling shall void any incidental home country coverage.
Benefit Period Medical Coverage
While the certificate is in effect, the benefit period does not apply. Upon termination of the certificate, including when you return to your home country, the benefit period applies for up to 90 days only to eligible medical expenses directly related to an injury or illness that was diagnosed or treated while the certificate was in effect. The benefit period begins on the first day of diagnosis or treatment of a covered injury or illness made while you are outside your home country. The benefit period applies whether or not you return to your home country.
Enrollment
You may access the online quoting and purchasing system or you may apply over the phone as well by calling us.
Claim Filing
You may file a claim by completing and submitting a Claimant’s Statement and Authorization form along with proof of claim (itemized bills, payment receipts, etc.).
You may complete and submit the form and necessary attachments online OR you may download the claim form and submit it alongside proof of claim via postal mail to the address on the form.
We must receive proof of claim within 60 days of the last day of your certificate period (or for claims incurred during a benefit period, 60 days from the date the claim is incurred)
Outstanding Customer Service
MyAccount is an online account management and resource tool available to:
- Extend coverage and reprint ID cards
- Obtain claim forms and information about filing
- Locate providers within the PPO Network
If you prefer to speak to a professional service representative, contact us by calling toll-free from various countries. The World Service Center can provide service in many different languages.
Worldwide Travel and Medical Assistance
ExchangeGuard includes valuable travel and medical assistance services, which are available 7 days a week, 365 days a year. Contact the administrator to access any of these services.
Medical Monitoring
Consultations with attending medical professionals during hospitalization and establishment of a single point-of-contact for family members to receive ongoing updates regarding medical status.
Provider Referrals
Contact information for Western-style medical facilities, medical and dental practices, and pharmacies in the destination country.
Travel Document Replacement
Assistance with obtaining replacement passports, birth certificates, visas, airline tickets, and other travel-related documents.
Lost Luggage Assistance
Tracking service to assist in locating luggage or other items lost in transit.
Other Travel Assistance Services*
- Prescription Drug Replacement
- Emergency Travel Arrangements
- Dispatch of Physician
- Translation Assistance
- Credit Card / Traveler's Check Replacement
* For a complete list of available assistance services or for more information, please contact the administrator. Travel and medical assistance services are not insurance benefits. Any travel or medical assistance service provided is not a guarantee of any insurance benefit.
ExchangeGuard® Essential Individual Rates (12 Month Pre-Existing Condition Waiting Period)
80% Coinsurance Option
| $0 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.07 | $2.15 | $2.57 |
| 25-29 | $2.41 | $2.50 | $3.00 |
| 30-39 | $2.55 | $2.78 | $2.82 |
| 40-49 | $2.71 | $2.86 | $3.21 |
| 50-64 | $5.11 | $6.00 | $6.42 |
| $100 Deductible per Injury/Illness | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.56 | $1.62 | $1.95 |
| 25-29 | $1.82 | $1.89 | $2.28 |
| 30-39 | $1.93 | $2.11 | $2.14 |
| 40-49 | $2.04 | $2.17 | $2.44 |
| 50-64 | $3.87 | $4.54 | $4.86 |
| $250 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.49 | $1.55 | $1.86 |
| 25-29 | $1.74 | $1.80 | $2.17 |
| 30-39 | $1.84 | $2.01 | $2.05 |
| 40-49 | $1.96 | $2.08 | $2.33 |
| 50-64 | $3.70 | $4.34 | $4.64 |
| $500 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.31 | $1.37 | $1.64 |
| 25-29 | $1.53 | $1.59 | $1.91 |
| 30-39 | $1.62 | $1.77 | $1.80 |
| 40-49 | $1.72 | $1.82 | $2.05 |
| 50-64 | $3.25 | $3.82 | $4.09 |
100% Coinsurance Option
| $0 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.61 | $2.72 | $3.26 |
| 25-29 | $3.05 | $3.17 | $3.80 |
| 30-39 | $3.22 | $3.52 | $3.57 |
| 40-49 | $3.42 | $3.62 | $4.07 |
| 50-64 | $6.47 | $7.59 | $8.13 |
| $100 Deductible per Injury/Illness | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.98 | $2.06 | $2.47 |
| 25-29 | $2.31 | $2.40 | $2.88 |
| 30-39 | $2.44 | $2.67 | $2.71 |
| 40-49 | $2.59 | $2.74 | $3.09 |
| 50-64 | $4.90 | $5.75 | $6.16 |
| $250 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.89 | $1.96 | $2.35 |
| 25-29 | $2.20 | $2.29 | $2.74 |
| 30-39 | $2.33 | $2.55 | $2.59 |
| 40-49 | $2.48 | $2.62 | $2.95 |
| 50-64 | $4.68 | $5.50 | $5.89 |
| $500 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.66 | $1.73 | $2.08 |
| 25-29 | $1.94 | $2.01 | $2.42 |
| 30-39 | $2.05 | $2.24 | $2.28 |
| 40-49 | $2.18 | $2.31 | $2.60 |
| 50-64 | $4.12 | $4.84 | $5.18 |
ExchangeGuard® Choice Individual Rates (6 Month Pre-Existing Condition Waiting Period)
80% Coinsurance Option
| $0 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.83 | $2.94 | $3.52 |
| 25-29 | $3.30 | $3.43 | $4.11 |
| 30-39 | $3.49 | $3.81 | $3.88 |
| 40-49 | $3.71 | $3.93 | $4.41 |
| 50-64 | $7.01 | $8.22 | $8.81 |
| $100 Deductible per Injury/Illness | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.14 | $2.23 | $2.68 |
| 25-29 | $2.50 | $2.60 | $3.12 |
| 30-39 | $2.64 | $2.89 | $2.93 |
| 40-49 | $2.81 | $2.97 | $3.34 |
| 50-64 | $5.31 | $6.23 | $6.67 |
| $250 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.05 | $2.13 | $2.56 |
| 25-29 | $2.39 | $2.48 | $2.98 |
| 30-39 | $2.52 | $2.76 | $2.81 |
| 40-49 | $2.69 | $2.84 | $3.20 |
| 50-64 | $5.07 | $5.96 | $6.38 |
| $500 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.80 | $1.87 | $2.25 |
| 25-29 | $2.10 | $2.18 | $2.62 |
| 30-39 | $2.22 | $2.43 | $2.46 |
| 40-49 | $2.36 | $2.50 | $2.82 |
| 50-64 | $4.47 | $5.24 | $5.61 |
100% Coinsurance Option
| $0 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $3.58 | $3.72 | $4.46 |
| 25-29 | $4.18 | $4.33 | $5.20 |
| 30-39 | $4.42 | $4.83 | $4.90 |
| 40-49 | $4.70 | $4.97 | $5.58 |
| 50-64 | $8.87 | $10.41 | $11.16 |
| $100 Deductible per Injury/Illness | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.71 | $2.82 | $3.38 |
| 25-29 | $3.16 | $3.29 | $3.94 |
| 30-39 | $3.34 | $3.66 | $3.72 |
| 40-49 | $3.55 | $3.77 | $4.24 |
| 50-64 | $6.71 | $7.89 | $8.44 |
| $250 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.59 | $2.70 | $3.24 |
| 25-29 | $3.02 | $3.14 | $3.77 |
| 30-39 | $3.19 | $3.50 | $3.56 |
| 40-49 | $3.40 | $3.60 | $4.05 |
| 50-64 | $6.42 | $7.55 | $8.07 |
| $500 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.28 | $2.37 | $2.86 |
| 25-29 | $2.66 | $2.76 | $3.33 |
| 30-39 | $2.82 | $3.08 | $3.12 |
| 40-49 | $2.99 | $3.17 | $3.57 |
| 50-64 | $5.66 | $6.64 | $7.10 |
ExchangeGuard® Essential Group Rates (12 Month Pre-Existing Condition Waiting Period) (Groups of 5 or more people)
80% Coinsurance Option
| $0 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.56 | $1.61 | $1.90 |
| 25-29 | $1.98 | $2.06 | $2.43 |
| 30-39 | $2.13 | $2.33 | $2.31 |
| 40-49 | $2.23 | $2.36 | $2.60 |
| 50-64 | $4.28 | $5.02 | $5.27 |
| $100 Deductible per Injury/Illness | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.22 | $1.27 | $1.50 |
| 25-29 | $1.57 | $1.62 | $1.92 |
| 30-39 | $1.67 | $1.84 | $1.83 |
| 40-49 | $1.75 | $1.86 | $2.05 |
| 50-64 | $3.37 | $3.95 | $4.15 |
| $250 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.18 | $1.22 | $1.44 |
| 25-29 | $1.50 | $1.57 | $1.85 |
| 30-39 | $1.62 | $1.77 | $1.77 |
| 40-49 | $1.70 | $1.80 | $1.98 |
| 50-64 | $3.26 | $3.83 | $4.01 |
| $500 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.06 | $1.11 | $1.31 |
| 25-29 | $1.36 | $1.41 | $1.67 |
| 30-39 | $1.46 | $1.59 | $1.59 |
| 40-49 | $1.52 | $1.61 | $1.79 |
| 50-64 | $2.93 | $3.45 | $3.61 |
100% Coinsurance Option
| $0 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.87 | $1.95 | $2.30 |
| 25-29 | $2.39 | $2.49 | $2.93 |
| 30-39 | $2.57 | $2.81 | $2.80 |
| 40-49 | $2.69 | $2.84 | $3.14 |
| 50-64 | $5.16 | $6.06 | $6.37 |
| $100 Deductible per Injury/Illness | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.48 | $1.53 | $1.81 |
| 25-29 | $1.89 | $1.96 | $2.31 |
| 30-39 | $2.03 | $2.21 | $2.21 |
| 40-49 | $2.12 | $2.24 | $2.48 |
| 50-64 | $4.07 | $4.78 | $5.01 |
| $250 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.43 | $1.49 | $1.75 |
| 25-29 | $1.83 | $1.89 | $2.22 |
| 30-39 | $1.95 | $2.14 | $2.13 |
| 40-49 | $2.05 | $2.17 | $2.39 |
| 50-64 | $3.93 | $4.62 | $4.85 |
| $500 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.28 | $1.33 | $1.58 |
| 25-29 | $1.64 | $1.70 | $2.01 |
| 30-39 | $1.76 | $1.93 | $1.93 |
| 40-49 | $1.85 | $1.95 | $2.16 |
| 50-64 | $3.54 | $4.16 | $4.37 |
ExchangeGuard® Choice Group Rates (6 Month Pre-Existing Condition Waiting Period) (Groups of 5 or more people)
80% Coinsurance Option
| $0 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.04 | $2.12 | $2.49 |
| 25-29 | $2.61 | $2.70 | $3.19 |
| 30-39 | $2.80 | $3.05 | $3.05 |
| 40-49 | $2.93 | $3.10 | $3.42 |
| 50-64 | $5.62 | $6.59 | $6.93 |
| $100 Deductible per Injury/Illness | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.60 | $1.67 | $1.97 |
| 25-29 | $2.05 | $2.13 | $2.51 |
| 30-39 | $2.20 | $2.41 | $2.39 |
| 40-49 | $2.30 | $2.44 | $2.69 |
| 50-64 | $4.42 | $5.19 | $5.45 |
| $250 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.56 | $1.61 | $1.90 |
| 25-29 | $1.99 | $2.06 | $2.43 |
| 30-39 | $2.12 | $2.33 | $2.32 |
| 40-49 | $2.23 | $2.36 | $2.60 |
| 50-64 | $4.28 | $5.02 | $5.27 |
| $500 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.40 | $1.45 | $1.71 |
| 25-29 | $1.78 | $1.85 | $2.19 |
| 30-39 | $1.92 | $2.09 | $2.08 |
| 40-49 | $2.00 | $2.12 | $2.35 |
| 50-64 | $3.85 | $4.52 | $4.74 |
100% Coinsurance Option
| $0 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $2.46 | $2.55 | $3.01 |
| 25-29 | $3.14 | $3.26 | $3.84 |
| 30-39 | $3.38 | $3.69 | $3.67 |
| 40-49 | $3.54 | $3.74 | $4.12 |
| 50-64 | $6.78 | $7.96 | $8.36 |
| $100 Deductible per Injury/Illness | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.94 | $2.02 | $2.38 |
| 25-29 | $2.48 | $2.57 | $3.03 |
| 30-39 | $2.66 | $2.92 | $2.91 |
| 40-49 | $2.78 | $2.95 | $3.26 |
| 50-64 | $5.34 | $6.26 | $6.59 |
| $250 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.87 | $1.94 | $2.30 |
| 25-29 | $2.39 | $2.49 | $2.93 |
| 30-39 | $2.57 | $2.82 | $2.81 |
| 40-49 | $2.69 | $2.85 | $3.14 |
| 50-64 | $5.16 | $6.07 | $6.36 |
| $500 Deductible | |||
| Maximum Limit | $100,000 | $250,000 | $500,000 |
| Age | Daily | Daily | Daily |
| 0-24 | $1.69 | $1.76 | $2.07 |
| 25-29 | $2.16 | $2.24 | $2.65 |
| 30-39 | $2.31 | $2.53 | $2.52 |
| 40-49 | $2.42 | $2.57 | $2.84 |
| 50-64 | $4.65 | $5.46 | $5.73 |
Administrator
WorldTrips4 Carter Green, Suite 400
Carmel, IN 46032
FOR ADDITIONAL INFORMATION
Moga Insurance Agency1440 N Harbor Blvd Suite 831
Fullerton, CA 92835
United States
Phone: 714-602-1514
Fax:
716-333-6731
Website: moga.brokersnexus.com
This insurance is not subject to, and does not provide certain insurance benefits required by the United States' Patient Protection and Affordable Care Act ("PPACA"). PPACA requires certain US citizens or US residents to obtain PPACA compliant health insurance, or "minimum essential coverage." PPACA also requires certain employers to offer PPACA compliant insurance coverage to their employees. Tax penalties may be imposed on U.S. residents or citizens who do not maintain minimum essential coverage, and on certain employers who do not offer PPACA compliant insurance coverage to their employees. In some cases, certain individuals may be deemed to have minimum essential coverage under PPACA even if their insurance coverage does not provide all of the benefits required by PPACA. You should consult your attorney or tax professional to determine whether this policy meets any obligations you may have under PPACA.
ExchangeGuard is underwritten by Lloyd's. WorldTrips is a service company and a member of the Tokio Marine HCC group of companies. WorldTrips has authority to enter into contracts of insurance on behalf of the Lloyd's underwriting members of Lloyd's Syndicate 4141, which is managed by HCC Underwriting Agency Ltd.
Version:
KHE2FFFYH6SP-971744701-1133
04/11/2024