Page 6 - Comparison of BLANK verses StudentSecure Plan of Tokio Marine HCC
P. 6
Enrollment of Spouse and dependent a. Eligible international students who enroll may Eligible enrolled student cannot purchase insurance for
children. also purchase insurance for their dependents: spouse and dependent children. However, family may enroll
legal spouse, dependent children under 26, in
Premiums: including domestic partners. Check visa status Not available integrated with Student’s insurance.
for dependents.
May be stipulated by School International Travelers Medical Insurance available from
Out-of-Pocket Maximum b. Dependent Eligibility expires concurrently with Tokio Marine HCC from 2 to 364 days at any one time. Has
that of the Insured student. three plans for individual and families.
This may be School specific - Atlas Essential
Requirement c. U.S. citizens are not eligible for coverage as a - Atlas Travel
Inpatient/Outpatient Prescription student or a dependent. - Atlas Premium
Medication: Must include coverage of Based on duration of semester or annual. Min payments are
$1,000 or more per policy year. Based on duration of semester or annual. Minimum on monthly basis.
Item is not listed in FL state minimum payments are on monthly basis.
requirements. Not stipulated. Payment of premiums is included in the tuition and Follow instruction to on site to get quotes online and sign
are paid to insurer for the committed semester. up.
Based on deductible plus defined coinsurance for the plan.
ESSENTIAL: No ceiling. (Deductible plus coinsurance.) No ceiling on Out-of-Pocket expense.
BRONZE: No ceiling. (Deductible plus coinsurance.)
SILVER: PPO: ELITE:
- $6,300 per person per year. $12,700 for all Generic Drugs: 100% Coinsurance. Brand Name Drugs: 50%
coinsurance. Specialty Drugs: No coverage.(not subject to
Insured in a family. deductible. Vaccinations: Up to $150 covered.
- Non-PPO: $8,000 per Insured person, $16,000
SELECT, BUDGET, and SMART:
for all Insureds in a Family 50% actual charge ( not subject to deductible or
ELITE: coinsurance). Vaccinations: No coverage.
- In-Network: $3,000 Per Insured Person per
No restriction on pharmacy.
Policy Year. $6,000 for all Insured in a family.
- Out-of-Network: $7,000 per Insured. $14,000 for
all insureds in family, per policy year.
In-Network only for all plans. No benefit for Out-of-
Network.
ESSENTIAL: For PPO: No benefits. For Non-PPO:
$1,000 max having 70% of Usual and Customary
charges.
BRONZE / SILVER / ELITE: Insurer’s controlled
Pharmacy:
- $20 Copay per prescription for Tier 1
- 30% Coinsurance per prescription for Tier 2
- 40% Coinsurance per prescription for Tier 3
If you need Specialty Prescription Drugs, there are
BLANK Designated Pharmacy stores available.
Preventive Care Services: It is sickness and injury related policy. This is not It is sickness and injury related policy. This is not available.
available. See Exceptions / Exclusions. See Exceptions / Exclusions.
children. also purchase insurance for their dependents: spouse and dependent children. However, family may enroll
legal spouse, dependent children under 26, in
Premiums: including domestic partners. Check visa status Not available integrated with Student’s insurance.
for dependents.
May be stipulated by School International Travelers Medical Insurance available from
Out-of-Pocket Maximum b. Dependent Eligibility expires concurrently with Tokio Marine HCC from 2 to 364 days at any one time. Has
that of the Insured student. three plans for individual and families.
This may be School specific - Atlas Essential
Requirement c. U.S. citizens are not eligible for coverage as a - Atlas Travel
Inpatient/Outpatient Prescription student or a dependent. - Atlas Premium
Medication: Must include coverage of Based on duration of semester or annual. Min payments are
$1,000 or more per policy year. Based on duration of semester or annual. Minimum on monthly basis.
Item is not listed in FL state minimum payments are on monthly basis.
requirements. Not stipulated. Payment of premiums is included in the tuition and Follow instruction to on site to get quotes online and sign
are paid to insurer for the committed semester. up.
Based on deductible plus defined coinsurance for the plan.
ESSENTIAL: No ceiling. (Deductible plus coinsurance.) No ceiling on Out-of-Pocket expense.
BRONZE: No ceiling. (Deductible plus coinsurance.)
SILVER: PPO: ELITE:
- $6,300 per person per year. $12,700 for all Generic Drugs: 100% Coinsurance. Brand Name Drugs: 50%
coinsurance. Specialty Drugs: No coverage.(not subject to
Insured in a family. deductible. Vaccinations: Up to $150 covered.
- Non-PPO: $8,000 per Insured person, $16,000
SELECT, BUDGET, and SMART:
for all Insureds in a Family 50% actual charge ( not subject to deductible or
ELITE: coinsurance). Vaccinations: No coverage.
- In-Network: $3,000 Per Insured Person per
No restriction on pharmacy.
Policy Year. $6,000 for all Insured in a family.
- Out-of-Network: $7,000 per Insured. $14,000 for
all insureds in family, per policy year.
In-Network only for all plans. No benefit for Out-of-
Network.
ESSENTIAL: For PPO: No benefits. For Non-PPO:
$1,000 max having 70% of Usual and Customary
charges.
BRONZE / SILVER / ELITE: Insurer’s controlled
Pharmacy:
- $20 Copay per prescription for Tier 1
- 30% Coinsurance per prescription for Tier 2
- 40% Coinsurance per prescription for Tier 3
If you need Specialty Prescription Drugs, there are
BLANK Designated Pharmacy stores available.
Preventive Care Services: It is sickness and injury related policy. This is not It is sickness and injury related policy. This is not available.
available. See Exceptions / Exclusions. See Exceptions / Exclusions.
