INF Elite Network

Plan Detail

Plan Administrator: INF Healthcare | AM Best Rating : "A++" | Underwriter: CHUBB American Insurance Company.

Benefits


SCHEDULE OF BENEFIT

MEDICAL EXPENSE BENEFITS – ACCIDENT AND SICKNESS

PRE-EXISTING CONDITIONS COVERAGE

This feature of the INF HEALTH CARE’S Accident and Sickness Insurance Program provides coverage for Pre-Existing Conditions, defined as an illness, disease, or other condition of the Covered Person that before the Covered Person’s coverage became effective under the Policy: (1) first manifested itself, worsened, became acute, or exhibited symptoms that would have caused a person to seek diagnosis, care, or treatment; or (2) required taking prescribed drugs or medicines, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or (3) was treated by a Doctor or treatment had been recommended by a Doctor.

Pre-Existing Conditions coverage is subject to a Maximum Benefit of $25,000 and Deductible of $1,500 (Age 69 & under) or a Maximum Benefit of $20,000 and Deductible of $1,500 (Ages 70-99). Pre-existing conditions covers pre-existing conditions on par with accidents and new sicknesses subject to special deductible and specific pre-existing policy maximum as specified above

MEDICAL EXPENSE BENEFITS We will pay Medical Expense Benefits for Covered Expenses that result directly, and from no other cause, from a Covered Accident or Sickness. These benefits are subject to a Deductible of $500 per person for each Injury and each Sickness. The Policy Maximum for all Accident and Sickness Benefits is $150,000 (Age 69 & under) and $75,000 (Ages 70-99). Benefits are also subject to the following:

Co-Insurance Limits:

In-Network: 80% of covered Network charges up to the overall maximum benefit.

Out-of-Network: 60% of covered Network charges up to the overall maximum benefit.

Deductible per individual sickness or injury: $500.

Policy Maximum Benefits per individual sickness or injury: $150,000 - Age 69 and under; $75,000 - Age 70-99.

Pre existing deductible per individual sickness or injury: $1,500.

Pre Existing Maximum Benefits per individual sickness or injury: $25,000 - Age 69 and under; $20,000 - Age 70-99.

Co-Insurance Limits In-Network: 80% of covered Network charges to the overall maximum benefit. Out-of-Network: 60% of covered Up to the overall maximum benefit.

Network Provider: FirstHealth Network

Network means the FirstHealth Network. When a covered Injury or Sickness requires treatment by a Doctor, this Policy will provide benefits while coverage is in force for the Usual and Customary charges incurred which exceed the deductible per person for each Injury or Sickness. Payment for any covered service will be no more than the Benefit Limit shown for it. In no event will the total combined benefits for a single Injury or Sickness (either in a single Policy year or through continuing year's coverage) exceed the Policy Maximum Benefit. Medical Expense Benefits are only payable: (1) for Usual and Customary Charges incurred after the Deductible, if any, has been met; (2) for those Medically Necessary Covered

Expenses that the Covered Person incurs; (3). for charges incurred for services rendered to the Covered Person while on a covered Trip; and (4) provided the first charge is incurred within 90 days of the Covered Accident or Sickness. Payment for Covered Expenses will not exceed the Policy Maximum shown above.

Covered Medical Expenses include:

PERIODS OF COVERAGE & PREMIUM RATES

Premium Rates in all tables (www.infplans.com/inf-easy-select-premiums.php) are per month (30 days coverage) and any single days premium is prorated based on 30 day monthly premium

Enrollment is subject to the following rules:

PROGRAM ELIGIBILITY

You are eligible to elect this insurance is you are an active member of the INF and are visiting the USA or Canada. Members are auto-enrolled in membership by paying $15 application fee. Membership expires at the termination date of each policy. Membership fees are required for new applications & renewals.

All Visitors & Travelers to the United States (included Non-US Citizens & US Citizen Expatriates visiting the United States) are eligible to enroll in this policy. You may elect coverage for your Eligible Dependents traveling with you. 

Eligible Dependents are any of the following persons: the insured member's legal spouse, and their unmarried dependent children under 19 years of age (19 years and older if a child is incapable of self-sustaining employment due to physical or mental handicap).

If adoption, birth or marriage occurs while the insured member is covered under this insurance, the insured member will have 31 days within which to enroll a newly eligible dependent and pay the required premium for coverage to continue for the remainder of the period of coverage.

INSURANCE ENROLLMENT

To enroll in the INF HEALTH CARE Accident & Sickness Insurance Program, you may enroll online or submit paper application from your agent. Click here to complete application online. To enroll in the health plans offered, follow the steps listed below:

1. Complete the Insurance Enrollment Form

2. Submit the forms either electronically or as shown below.

VIA FAX: 

Fax the membership and enrollment forms (fax versions of the forms are available under download link) with charge authorization to 408-520-4967

VIA MAIL:

Mail a check for the exact amount with completed enrollment forms: the membership form & insurance form. Prepare two checks:

1. Application fee of $15 made payable to INF Health Care, LLC and

2. Premium amount made payable to ‘INF Health Care, LLC’ and mail the package to:

INF Health Care
7065 Westpointe Blvd, Suite 209 
Orlando, FL 32835-8758

Processing of an insurance enrollment may take up to 2 working days; when processing is complete, if you enroll for a coverage term of 1 month or more. Fulfillment is completed electronically. Physical delivery of an ID card is subject to an additional $5 processing fee. Requests may be submitted to operations@infplans.com

AXA Travel ASSISTANCE SERVICES (AVAILABLE FOR INSURED MEMBERS ONLY

AXA Travel Assistance Services at 1-855-327-1414 will provide 24-hour access to the following services:

You will receive information Travel Assistance on your Certificate of Insurance that will provide you with emergency call numbers. Information on how to access CHUBB’s Travel Assistance Web Portal can be found in the brochure for this plan.

This information provides you with a brief outline of the services available to you. These services are subject to the terms and conditions of the Policy under which you are insured. Travel assistance services are not available if your coverage under the Policy providing insurance benefits is not in effect

Other Policies Features

Accidental Death and Dismemberment**

$25,000 Maximum

Pre-certification

Not Required

Type of Coverage

Excess

Benefit Period

36 Months

EMERGENCY MEDICAL EVACUATION AND REPATRIATION OF REMAINS BENEFITS*

Emergency Medical Evacuation Benefit- We will pay up to the maximum indicated above in the Schedule of Benefits for your medical evacuation if you: 1) suffer a Medical Emergency during the course of the Trip; 2) require Emergency Medical Evacuation; and 3) are traveling on a covered Trip.

Covered Expenses include;

1) Medical Transport: expenses for transportation under medical supervision to a different hospital, treatment facility or to your place of residence for Medically Necessary treatment in the event of your 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, your 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 your 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) you are age 18 or older; and b) you are the only person traveling with the minor Dependent child(ren); and c) you suffer 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 you to join you during your emergency medical evacuation to a different hospital, treatment facility or your 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 your 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 Usual and Customary Charges 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.

Benefits will not be payable unless We authorize in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by Our assistance provider. In the event you refuse to be medically evacuated, we will not be liable for any medical expenses incurred after the date medical evacuation is recommended.

Repatriation of Remains Benefit

We will pay up to the maximum indicated above in the Schedule of Benefits for the preparation and return of your body to your home if you die as a result of a Medical Emergency while traveling on a covered Trip.

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 which include expenses for an Immediate Family Member or companion who is traveling with you to join your body during the repatriation to your place of residence.

All transportation arrangements must be made by the most direct and economical route and conveyance possible and may not exceed the Usual and Customary Charges for similar transportation in the locality where the expense is incurred. Benefits will not be payable unless We authorize in writing, or by an authorized electronic or telephonic means, all expenses in advance, and services are rendered by Our assistance provider

ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS of $25,000**

Definition of Injury and Scope of Coverage – 24 Hour Coverage

Principal Sum for Covered Injury: $25,000

Accidental Death and Dismemberment Benefits - If your Injury results, within 365 days from the date of a Covered Accident, in any one of the losses shown below, We will pay the Benefit Amount shown below for that loss. Principal Sum for you and your Dependents (if you have elected Dependent coverage and the required premium has been paid) is $25,000. If multiple losses occur, only one Benefit Amount, the largest, will be paid for all losses due to the same Covered Accident.

Schedule of Covered Losses

Covered Loss Benefit Amount

Life......................... 100% of the Principal Sum

Two or more Members....................... 100% of the Principal Sum

One Member...................... 50% of the Principal Sum

“Member means Loss of Hand or Foot, and Loss of Sight. “Loss of Hand or Foot" means complete Severance through or above the wrist or ankle joint. “Loss of Sight” means the total, permanent Loss of Sight of one eye. Severance means the complete separation and dismemberment of the part from the body.

Aggregate Limit - We will not pay more than $125,000 for all losses. If, in the absence of this provision, We would pay more than this amount for all losses under the policy, then the benefits payable to each person with a valid claim will be reduced proportionately.