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International > Group Health Insurance > HCC Medical Insurance Services >

International Group Health Insurance

International Group Health Insurance


GroupSecure Plan
Medical/Surgical Benefit Limit
Maximum Limit $1,000,000 Lifetime or $5,000,000 Lifetime
Individual Deductible Options $150, $250, $500, $1,000 or $2,500
Family Deductible Maximum of 3 Deductibles per Family per Calendar Year
Individual Out-of-Pocket Limit $1,000 after the Deductible per Calendar Year
Inpatient Prescription Drugs Usual, Reasonable and Customary (Subject to Deductible and Coinsurance).
Transplant Expense Subject to Special Transplant Pre-certification Requirements. Treatment is provided within the PPO. Covered Transplants are: Heart, Heart/Lung, Lung, Kidney, Kidney/Pancreas, Liver and Allogeneic and Autologous Bone Marrow.
Second Surgical Opinion Subject to Deductible and Coinsurance unless requested by HCCMIS (payable at 100% if requested by HCCMIS)
Maternity & Newborn Care Same as any other Illness after 10 months of continuous coverage, including $500 per Calendar Year for Midwife Services.  Subject to Special Maternity Pre-certification Requirements.
Hospital Room and Board Average Semi-private room rate, including nursing service
Intensive Care Unit Usual, Reasonable, and Customary

Medical Plan Payment Percentages
Benefit
Outside the US
Inside the US
(In-Network)
Inside the US
(Out-of-Network)
Hospital Services
100%
100%
80%
Physician Services
100%
100%
80%
Inpatient Treatment
100%
100%
80%
Outpatient Treatment
100%
100%
80%
Surgery
100%
100%
80%
Physical Therapy and Chiropractic Care ($50 per visit; must be presecribed by medical doctor in relation to covered condition)
100%
100%
80%
Local Ambulance
$3,000 per Calendar Year
100%
100%
80%
Eligible Medical Expenses
100%
100%
80%

Individual Out-of-Pocket Expenses

After the Deductible, Insured PErsonas are responsible for 20% of the next $5,000 of Eligible Expenses incurred within the US and Canada.  This coinsurance will be waived if expenses are incurred within the Perferred Provider Organization and expenses are submitted to HCCMIS for review and payment directly to the provider.

US Preferred Provider Organization (PPO)

When seeking treatment in the US, Insured Persons may elect to seek treatment from a provider within the Hygeia PPO network to reduce out-of-pocket expenses.  The PPO online directory allows Insured Persons to search for facilities or practitioners with in the area where treatment will be sought.


Optional Benefit Packages
Benefit Limit
Preventative Package Preventative benefits are available after 12 months of coverage and are not subject to Deductible Dependent children under 19:  $75 per visit (including immunizations), maximum of 3 visits per Calendar Year
Employees & Dependents age 30 and above: $250 per Insured Person per Calendar Year
Female Insured Persons age 40 and over (or qualifying Woman at Risk as herein defined):  $100 per Insured Person per Calendar Year for a screening mammogram
Emergency Assistance Package Emergency Medical Evacuation:  for Insured Persons under the age of 65
  • Option 1:  $50,000 Lifetime Maximum
  • Option 2:  $100,000 Lifetime Maximum
  • Option 3:  $150,000 Lifetime Maximum
Emergency Reunion:  $15,000 per Calendar Year Repatriation of Remains:  $25,000 Maximum per Insrued Person
Mental Health Disorders $25,000 Lifetime Maximum after 12 months of continuous coverage, subject to the following sub-limits: Outpatient Treatment: 50% of a Maximum charge of $100 per visit with a Maximum of 52 visits per Calendar Year per Insured Person. Inpatient Treatment: Limited to $10,000 per Calendar Year per Insured Person.
Hospital Indemnity $100 per day, seven day maximum (excluding hospitalization for maternity)

Vision Package

After 12 months of continuous coverage and s ubject to $50 Deductible. Covered up to $150 every 24 months for routine eye exam. Covered up to $100 every 24 months for corrective lenses, contacts and frames
Term Life and AD&D For groups with 10 or fewer employees, group term life insurance is automatically included.  For larger groups, term life insurance is optional.  Life insurance is available in amounts of $10,000, $25,000, $50,000 or a multible of salary up to $125,000

 

Dental Plan Benefits
  
Outpatient Prescription Benefits
Type
Option 1
Option 2
Option 3
Plan Maximum
$1,000
$1,000
$1,500
Deductible (Max 3 per family)
$100
$50
$0
Class A - Preventative & Diagnostic
100%
100%
100%
Class B - Basic Dental Procedures
80%
80%
80%
Class C - Major Dental Procedures
50%
50%
50%
Orthodontia ($2,000 Life Max)
No Coverage
50%
50%
 
Option
Benefit
Subject to Deductible & Coinsurance
Option 1
Drug card (US only):
$15 copay generic
$30 copay brand name (including Mail order)
No*
Option 2
Usual, Reasonable and Customary charges
Yes
Option 3
50% of Usual, Reasonable and Customary charges
Yes

*When prescription expenses are incurred in the US or Canada without presenting the card at time of purchase, expenses are subject to Deductible and Coinsurance instead of Copay.

Outpatient Prescription Drug Card

If this option is selected, each employee will receive a Prescription Drug Card recognized by 98% of the pharmacy outlets in the US..

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