If travel excludes USA, see Atlas International Group - Travel Medical Insurance.
The Atlas America Group plan is with you and your group of 5 or more almost anywhere you may travel in the world. Atlas America Group coverage is designed for mission trips, family vacations, student groups, corporate groups, and overseas excursions for other organizations.
Why Choose Atlas America Group?
Whatever your reason for venturing abroad with a group, we believe international travel should be pleasant experience. However, travel mishaps and emergencies such as illness, Injury, and natural disasters can happen despite preparation - and they can be even tougher to manage for a group.
America Group international travel medical insurance plan includes coverage for unexpected medical expenses, emergency travel benefits, and multilingual travel assistance services.
My family has medical insurance in our home country; do we need group travel medical insurance?
Often, the primary medical insurance in your home country will not cover you and your family while traveling internationally, and medical expenses can be very costly while abroad. Atlas America Group plans offer budget-friendly coverage—plans start at less than $1 per person per day!
Additionally, Atlas America Group includes important travel assistance services such as translation assistance while being treated, 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 products 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, that act independently to deliver effective solutions. Our products and capabilities set the standard for the industry, as many of our nearly 3,000 employees are industry-leading experts. Tokio Marine HCC is part of Tokio Marine Group, a premier global company with a market cap of approximately $36 billion as of December 31, 2020.
For more information about Atlas America Group , please call us.
Atlas America Group Schedule of Benefits and Limits
Plan Details | |
---|---|
Deductibles | $0, $100, $250, $500, $1,000, $2,500 or $5,000 per certificate period. |
Overall Maximum Limit | Age 80 or older - $10,000; Age 65 to 79 - $50,000, or $100,000; All others - $50,000, $100,000, $250,000, $500,000, $1,000,000 or $2,000,000. |
Coinsurance | We will pay 100% of eligible expenses after the deductible up to the overall maximum limit. |
Eligible expenses are subject to deductible, overall maximum limit, 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 overall maximum limit. |
Emergency Room Co-payment | Claims Incurred in U.S You shall be responsible for a $200 co-payment for the emergency room facility fee for each use of emergency room for an illness unless you are 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 | Claims Incurred in the U.S. For each visit, you shall be responsible for a $15 co-payment. - co-payment is waived for members with a $0 deductible - not subject to deductible Claims incurred outside the U.S. No co-payment |
Outpatient Physical Therapy and Chiropractic Care | Up to $50 maximum per day. |
Emergency Dental | Up to $300 - not subject to deductible |
Emergency Eye Exam Copayment | Up to $150. $50 copayment per occurrence (plan deductible is waived). |
Acute Onset of Pre-existing Condition See benefit description | Up to the overall maximum limit. Up to $25,000 lifetime maximum for Emergency Medical Evacuation. |
Terrorism | Up to $50,000 lifetime maximum. Eligible medical expenses only. |
All Other Eligible Medical Expenses | Up to the overall maximum limit. |
Emergency Travel Benefits | Limit |
Emergency Medical Evacuation | Up to $1,000,000 lifetime maximum, except as provided under Acute Onset of Pre-existing Condition. - not subject to deductible or overall maximum limit |
Return of Minor Children | Up to $50,000 - not subject to deductible |
Pet Return | Up to $1,000 - not subject to deductible |
Repatriation of Remains |
Equal to the elected overall maximum limit - not subject to deductible or coinsurance This limit is for this benefit only and is not included in or subject to the overall maximum limit. |
Emergency Reunion | Up to $100,000, subject to a maximum of 15 days - not subject to deductible |
Natural Disaster - Replacement Accommodations | Up to $250 a day for up to 5 days - not subject to deductible |
Trip Interruption | Up to $10,000 - not subject to deductible |
Travel Delay | Up to $100 a day after a 12-hour delay period requiring an unplanned overnight stay. Subject to a maximum of 2 days. - not subject to deductible |
Lost Checked Luggage | Up to $1,000 - not subject to deductible |
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 |
Accidental Death and Dismemberment (excludes loss due to common carrier accident) $250,000 maximum benefit any one family or group. - not subject to deductible, or overall maximum limit | |
Ages 18 through 69 | Lifetime Maximum - $25,000 Death - $25,000 Loss of 2 Limbs - $25,000 Loss of 1 Limb - $12,500 |
Under age 18 | Lifetime Maximum - $5,000 Death - $5,000 Loss of 2 Limbs - $5,000 Loss of 1 Limb - $2,500 |
Ages 70 through 74 | Lifetime Maximum - $12,500 Death - $12,500 Loss of 2 Limbs - $12,500 Loss of 1 Limb - $6,250 |
Ages 75 and older | Lifetime Maximum - $6,250 Death - $6,250 Loss of 2 Limbs - $6,250 Loss of 1 Limb - $3,125 |
Optional Accidental Death & Dismemberment Rider (only available to members age 18 through age 69) |
Lifetime Maximum - $25,000 Death - $25,000 Loss of 2 Limbs - $25,000 Loss of 1 Limb - $12,500 - not subject to deductible or overall maximum limit |
Common Carrier Accidental Death |
Ages 18 through 69:$50,000 Under age 18: $10,000 Ages 70 through 74: $25,000 Ages 75 and older: $12,500 Subject to a maximum of $250,000 any one family or group. - not subject to deductible, or overall maximum limit |
Crisis Response - Ransom, Personal Belongings, and Crisis Response Fees and Expenses | Up to $10,000 - not subject to deductible, or overall maximum limit |
Hospital Indemnity | Up to $10,000 - not subject to deductible or overall maximum limit |
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 overall maximum limit |
Optional Personal Liability Rider | Lifetime Maximum - $75,000 Third-Person Injury - Up to $75,000 Third-Person Property - Up to $75,000 Related Third-Person Property - Up to $7,500 - not subject to deductible or overall maximum limit |
Bedside Visit | Up to $1,500 - not subject to deductible |
Border Entry Protection | Up to $500 if traveling on a valid B-2 visa and denied entrance at the U.S. border - not subject to deductible |
What's Covered by Atlas America Group?
Emergency Medical Evacuation and Emergency Reunion
Would you know what to do if you found yourself in a life-threatening situation far from home? Atlas America Group 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. Atlas America Group 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, Atlas America Group will arrange for and cover the eligible 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, Atlas America Group will cover the transportation cost for the children to return home.
Terrorism
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, Atlas America Group 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 level 3 or higher travel advisory for your destination country, Atlas America Group will coordinate your alternate departure arrangements from that country and cover eligible associated costs.
Natural Disaster Benefit - Replacement Accommodations
If a natural disaster occurs while on your trip, causing you to become displaced from your planned and paid accommodations, Atlas America Group will provide relief of a maximum of $250 a day for 5 days to help cover the costs of alternative accommodations.
Hospital Indemnity
If you are hospitalized, the world around you does not stop. What's more, in some places hospitals do not provide their patients basic necessities like meals, toothpaste or soap. If you are hospitalized as an inpatient for treatment of a covered illness or injury, Atlas America Group will provide $100 for each night you spend in the hospital.
Acute Onset of Pre-Existing Conditions
Atlas America Group provides a limited benefit up to the medical coverage lifetime maximum for eligible medical expenses. If you are younger than 80, you may be covered for an acute onset of a **pre-existing condition. This also includes up to a $25,000 lifetime maximum for emergency medical evacuation.
An acute onset of a pre-existing condition is a sudden and unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent care. A pre-existing condition that is a chronic or congenital, or that gradually becomes worse over time, is not acute onset of a pre-existing condition.
The Acute Onset of Pre-existing Condition benefit will only apply if all of the following conditions are met:
- The Acute onset of a Pre-Existing Condition does not directly or indirectly relate to a chronic condition or congenital condition;
- Treatment must be obtained within twenty-four (24) hours of the sudden and unexpected outbreak or reoccurrence;
- You must be under eighty (80) years of age;
- You must not be traveling against or in disregard of the recommendations, established treatment programs, or medical advice of a physician or other healthcare provider;
- You must not be traveling with the intent or purpose to seek or obtain treatment for the pre-existing condition;
- You must be traveling outside your home country
Hospitalization & Outpatient Treatment
If a covered illness or injury requires hospitalization, the plan provides coverage for eligible costs associated with hospitalization, including intensive care unit and outpatient treatment.
Sports Coverage
Atlas America Group includes coverage for eligible injuries and illnesses that could occur while participating in many popular vacation sports - skiing, snowboarding, snorkeling, water skiing, and others - at no additional cost. Certain extreme sports are excluded from coverage.
Complications of Pregnancy
Atlas America Group offers coverage for complications of pregnancy during the first 26 weeks of gestation.
Crisis Response
Atlas America Group offers up to $10,000 (or up to $100,000 if ***additional coverage is selected) 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 Crisis Group for advice, coordination with law enforcement, and negotiations during a kidnapping.
Personal Liability
Atlas America Group offers up to $25,000 (or up to $100,000 if additional coverage is selected) 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
Enrollment and Filing a Claim
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 call 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).
*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.
**A 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.
***A buy-up of an additional $90,000 is available for selection, which includes the added benefit of a $10,000 maximum for natural disaster evacuation.
Customer Service
MyAccount and World Service Center
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
Atlas America Group 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.
Rates
Atlas Group® America - For Non-US Citizens traveling to the U.S. (Groups of 5-24 People)
$0 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $2.05 | $2.56 | $2.85 | $3.58 | $4.08 | $4.28 |
18-29 | $2.10 | $2.61 | $2.91 | $3.65 | $4.16 | $4.37 |
30-39 | $2.51 | $3.38 | $3.96 | $4.21 | $4.66 | $4.91 |
40-49 | $3.30 | $4.01 | $4.52 | $5.37 | $6.16 | $6.48 |
50-59 | $5.45 | $6.74 | $8.33 | $9.46 | $10.39 | $10.92 |
60-64 | $7.40 | $9.49 | $12.59 | $13.72 | $15.06 | $15.84 |
65-69 | $8.64 | $10.79 | N/A | N/A | N/A | N/A |
70-79* | $14.89 | $18.59 | N/A | N/A | N/A | N/A |
80+** | $22.11 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$100 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.80 | $2.24 | $2.48 | $3.14 | $3.54 | $3.74 |
18-29 | $1.83 | $2.29 | $2.52 | $3.20 | $3.61 | $3.81 |
30-39 | $2.19 | $2.96 | $3.45 | $3.68 | $4.08 | $4.28 |
40-49 | $2.88 | $3.50 | $3.93 | $4.68 | $5.36 | $5.63 |
50-59 | $4.77 | $5.86 | $7.26 | $8.24 | $9.05 | $9.50 |
60-64 | $6.44 | $8.25 | $10.98 | $11.97 | $13.11 | $13.80 |
65-69 | $7.52 | $9.41 | N/A | N/A | N/A | N/A |
70-79* | $12.97 | $16.18 | N/A | N/A | N/A | N/A |
80+** | $19.25 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$250 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.43 | $1.79 | $1.97 | $2.48 | $2.84 | $2.98 |
18-29 | $1.46 | $1.83 | $2.02 | $2.54 | $2.90 | $3.04 |
30-39 | $1.74 | $2.35 | $2.75 | $2.94 | $3.24 | $3.41 |
40-49 | $2.28 | $2.80 | $3.14 | $3.72 | $4.27 | $4.47 |
50-59 | $3.80 | $4.67 | $5.79 | $6.55 | $7.21 | $7.58 |
60-64 | $5.15 | $6.56 | $8.74 | $9.51 | $10.45 | $10.98 |
65-69 | $5.99 | $7.49 | N/A | N/A | N/A | N/A |
70-79* | $10.32 | $12.88 | N/A | N/A | N/A | N/A |
80+** | $15.32 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$500 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.27 | $1.58 | $1.76 | $2.23 | $2.52 | $2.66 |
18-29 | $1.30 | $1.61 | $1.79 | $2.28 | $2.57 | $2.72 |
30-39 | $1.54 | $2.12 | $2.44 | $2.60 | $2.90 | $3.04 |
40-49 | $2.05 | $2.49 | $2.81 | $3.30 | $3.81 | $4.00 |
50-59 | $3.38 | $4.16 | $5.15 | $5.83 | $6.43 | $6.76 |
60-64 | $4.57 | $5.86 | $7.79 | $8.49 | $9.31 | $9.79 |
65-69 | $5.35 | $6.66 | N/A | N/A | N/A | N/A |
70-79* | $9.19 | $11.49 | N/A | N/A | N/A | N/A |
80+** | $13.66 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$1,000 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.12 | $1.39 | $1.54 | $1.94 | $2.21 | $2.33 |
18-29 | $1.13 | $1.41 | $1.57 | $1.97 | $2.26 | $2.38 |
30-39 | $1.35 | $1.85 | $2.12 | $2.30 | $2.53 | $2.66 |
40-49 | $1.77 | $2.18 | $2.45 | $2.90 | $3.33 | $3.50 |
50-59 | $2.95 | $3.65 | $4.51 | $5.11 | $5.62 | $5.90 |
60-64 | $4.00 | $5.14 | $6.81 | $7.43 | $8.16 | $8.57 |
65-69 | $4.66 | $5.84 | N/A | N/A | N/A | N/A |
70-79* | $8.04 | $10.05 | N/A | N/A | N/A | N/A |
80+** | $11.94 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$2,500 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.04 | $1.30 | $1.45 | $1.83 | $2.06 | $2.18 |
18-29 | $1.07 | $1.32 | $1.48 | $1.86 | $2.10 | $2.22 |
30-39 | $1.26 | $1.75 | $2.02 | $2.16 | $2.38 | $2.49 |
40-49 | $1.67 | $2.04 | $2.30 | $2.72 | $3.12 | $3.29 |
50-59 | $2.77 | $3.42 | $4.22 | $4.80 | $5.27 | $5.54 |
60-64 | $3.75 | $4.82 | $6.39 | $6.97 | $7.65 | $8.04 |
65-69 | $4.37 | $5.47 | N/A | N/A | N/A | N/A |
70-79* | $7.57 | $9.43 | N/A | N/A | N/A | N/A |
80+** | $11.20 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$5,000 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $0.86 | $1.09 | $1.26 | $1.60 | $1.81 | $1.91 |
18-29 | $0.88 | $1.12 | $1.29 | $1.63 | $1.85 | $1.94 |
30-39 | $1.04 | $1.46 | $1.75 | $1.88 | $2.10 | $2.20 |
40-49 | $1.39 | $1.74 | $2.00 | $2.39 | $2.74 | $2.89 |
50-59 | $2.27 | $2.89 | $3.67 | $4.19 | $4.64 | $4.88 |
60-64 | $3.08 | $4.10 | $5.55 | $6.11 | $6.71 | $7.07 |
65-69 | $3.59 | $4.66 | N/A | N/A | N/A | N/A |
70-79* | $6.02 | $7.79 | N/A | N/A | N/A | N/A |
80+** | $9.19 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
Atlas Group® America - For Non-US Citizens traveling to the U.S. (Groups of 25+ People)
$0 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.94 | $2.41 | $2.69 | $3.38 | $3.85 | $4.05 |
18-29 | $1.98 | $2.47 | $2.75 | $3.45 | $3.93 | $4.13 |
30-39 | $2.37 | $3.20 | $3.74 | $3.98 | $4.40 | $4.63 |
40-49 | $3.12 | $3.78 | $4.27 | $5.07 | $5.81 | $6.12 |
50-59 | $5.15 | $6.37 | $7.87 | $8.93 | $9.81 | $10.31 |
60-64 | $6.99 | $8.96 | $11.89 | $12.95 | $14.22 | $14.96 |
65-69 | $8.16 | $10.19 | N/A | N/A | N/A | N/A |
70-79* | $14.06 | $17.56 | N/A | N/A | N/A | N/A |
80+** | $20.88 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$100 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.70 | $2.12 | $2.34 | $2.97 | $3.34 | $3.53 |
18-29 | $1.73 | $2.16 | $2.38 | $3.03 | $3.41 | $3.60 |
30-39 | $2.07 | $2.80 | $3.26 | $3.48 | $3.85 | $4.04 |
40-49 | $2.72 | $3.31 | $3.71 | $4.42 | $5.07 | $5.31 |
50-59 | $4.51 | $5.53 | $6.86 | $7.79 | $8.54 | $8.98 |
60-64 | $6.08 | $7.79 | $10.37 | $11.31 | $12.38 | $13.03 |
65-69 | $7.10 | $8.89 | N/A | N/A | N/A | N/A |
70-79* | $12.25 | $15.28 | N/A | N/A | N/A | N/A |
80+** | $18.18 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$250 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.35 | $1.69 | $1.86 | $2.35 | $2.69 | $2.81 |
18-29 | $1.38 | $1.73 | $1.90 | $2.40 | $2.74 | $2.87 |
30-39 | $1.64 | $2.22 | $2.59 | $2.78 | $3.06 | $3.22 |
40-49 | $2.15 | $2.64 | $2.97 | $3.51 | $4.03 | $4.22 |
50-59 | $3.59 | $4.41 | $5.47 | $6.19 | $6.81 | $7.16 |
60-64 | $4.86 | $6.20 | $8.25 | $8.98 | $9.87 | $10.37 |
65-69 | $5.66 | $7.07 | N/A | N/A | N/A | N/A |
70-79* | $9.75 | $12.16 | N/A | N/A | N/A | N/A |
80+** | $14.47 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$500 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.20 | $1.49 | $1.66 | $2.11 | $2.38 | $2.52 |
18-29 | $1.22 | $1.52 | $1.69 | $2.15 | $2.42 | $2.57 |
30-39 | $1.45 | $2.00 | $2.30 | $2.46 | $2.74 | $2.87 |
40-49 | $1.94 | $2.35 | $2.65 | $3.12 | $3.60 | $3.77 |
50-59 | $3.19 | $3.93 | $4.86 | $5.51 | $6.07 | $6.38 |
60-64 | $4.32 | $5.53 | $7.35 | $8.02 | $8.79 | $9.25 |
65-69 | $5.05 | $6.29 | N/A | N/A | N/A | N/A |
70-79* | $8.68 | $10.85 | N/A | N/A | N/A | N/A |
80+** | $12.90 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$1,000 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $1.05 | $1.31 | $1.45 | $1.83 | $2.09 | $2.20 |
18-29 | $1.07 | $1.33 | $1.48 | $1.86 | $2.13 | $2.24 |
30-39 | $1.28 | $1.74 | $2.01 | $2.17 | $2.39 | $2.52 |
40-49 | $1.67 | $2.06 | $2.31 | $2.74 | $3.15 | $3.31 |
50-59 | $2.79 | $3.44 | $4.26 | $4.83 | $5.30 | $5.58 |
60-64 | $3.77 | $4.85 | $6.43 | $7.02 | $7.71 | $8.09 |
65-69 | $4.40 | $5.52 | N/A | N/A | N/A | N/A |
70-79* | $7.59 | $9.49 | N/A | N/A | N/A | N/A |
80+** | $11.28 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$2,500 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $0.99 | $1.22 | $1.37 | $1.73 | $1.95 | $2.06 |
18-29 | $1.01 | $1.25 | $1.39 | $1.76 | $1.98 | $2.10 |
30-39 | $1.19 | $1.65 | $1.90 | $2.04 | $2.24 | $2.35 |
40-49 | $1.58 | $1.93 | $2.17 | $2.57 | $2.95 | $3.10 |
50-59 | $2.62 | $3.23 | $3.99 | $4.53 | $4.98 | $5.23 |
60-64 | $3.54 | $4.55 | $6.04 | $6.58 | $7.23 | $7.59 |
65-69 | $4.12 | $5.17 | N/A | N/A | N/A | N/A |
70-79* | $7.15 | $8.91 | N/A | N/A | N/A | N/A |
80+** | $10.57 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
$5,000 Deductible | ||||||
---|---|---|---|---|---|---|
Maximum Limit | $50,000 | $100,000 | $250,000 | $500,000 | $1,000,000 | $2,000,000 |
Age | Daily | Daily | Daily | Daily | Daily | Daily |
14d-17y | $0.82 | $1.03 | $1.19 | $1.51 | $1.71 | $1.80 |
18-29 | $0.83 | $1.05 | $1.22 | $1.54 | $1.74 | $1.84 |
30-39 | $0.98 | $1.38 | $1.65 | $1.78 | $1.98 | $2.07 |
40-49 | $1.31 | $1.64 | $1.89 | $2.25 | $2.58 | $2.73 |
50-59 | $2.14 | $2.73 | $3.47 | $3.96 | $4.38 | $4.61 |
60-64 | $2.91 | $3.87 | $5.24 | $5.77 | $6.33 | $6.67 |
65-69 | $3.39 | $4.40 | N/A | N/A | N/A | N/A |
70-79* | $5.69 | $7.36 | N/A | N/A | N/A | N/A |
80+** | $8.68 | N/A | N/A | N/A | N/A | N/A |
*$100,000 Maximum Limit for ages 70-79; **$10,000 Maximum Limit for age 80 and over.
Rates are shown in US dollars and are effective 08/01/2024. Rates are subject to change. Charges will include Surplus Lines taxes and fees when applicable.
If for any reason you wish to cancel your policy, you must submit your cancellation request in writing to us in order to receive a refund or premium. Cancellation requests received after the policy effective date will be subject to the following conditions: 1) a $25 cancellation fee will apply; and 2) only the unused portion of the plan cost will be refunded; and 3) only members who have no claims are eligible for premium refund.
Administrator
WorldTrips4 Carter Green, Suite 400
Carmel, IN 46032
FOR ADDITIONAL INFORMATION
Alnic Inc.PO Box 470
Caldwell, NJ 07006
United States
Phone: 212-787-3405
Fax:
212-787-6502
Website: alnic.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.
Atlas America Group is underwritten by Lloyd's. The administrator is a service company and a member of the Tokio Marine HCC group of companies. The administrator 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-971744701-1238
08/01/2024