| | Benefits | Pricing | Brochure | FAQs | Exclusions | Enroll | Pricing For individuals traveling to the USA. Rates are based on a $250 deductible. |
| PLAN A
$50,000 Per
Condition | PLAN B
$100,000 per Condition | PLAN C
$250,000 Lifetime | Age | Month | Month | Month | 18-29 | $ 69.00 | $ 80.00 | $ 88.00 | 30-39 | $ 97.00 | $118.00 | $128.00 | 40-49 | $153.00 | $179.00 | $194.00 | 50-59 | $228.00 | $253.00 | $286.00 | 60-64* | $294.00 | $336.00 | N/A | 65-69** | $320.00 | N/A | N/A | 70-79** | $346.00 | N/A | N/A | 80+***($10,000 max.) | $535.00 | N/A | N/A | Dep. Child**** | $ 48.00 | $ 48.00 | $ 48.00 | Child Alone**** | $ 71.00 | $ 71.00 | $ 71.00 |
*Benefits reduce to $100,000 at age 60
** Benefits reduce to $50,000 at age 65
*** Benefits reduce to $10,000 at age 80 **** Benefits limited to $50,000
Deductable Factors: $250 x 1.00 $500 x .90 $1,000 x .80
Optional Rider Factors: Hazardous Activity x 1.15 Athletic x 1.10 Home Country x 1.15
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Policy terms and conditions are briefly outlined in this Description of Insurance. Complete provisions pertaining to this insurance plan are contained in the Master Policy which is on file with the Policyholder, Trustee of ACE USA Accident & Health Insurance Trust in the District of Columbia. In the event of any conflict between this Description of Coverage and the Master Policy, the Master Policy will govern. ACE USA is a division of ACE Corporation. Insurance products and services are provided by ACE insurance underwriting companies and not by the corporation itself. This Plan may not be available in all states. Personal Information Notification: All verification or changes for an Enrolled Person's information must be submitted to CMI Insurance in writing at 11311 McCormick Rd, Hunt Valley, MD 21031-8622. The Enrolled Person will receive a letter to either verify current information or to acknowledge the changes made within 30 days from receipt of the letter. |
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