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Patriot Group Travel Insurance Plan
Group of 5 or more US/ Non-US Citizens traveling together

Patriot Group Travel Plan


Patriot Group Travel coverage is designed for organizations who have a group of 5 or more US citizens or Non US Citizens traveling together, and to a destination that is not the home country of any of the traveling members. This plan provides the same benefits as the individual Patriot Travel Medical Insurance but with a 10% discounted rates for applying as a group. This plan offers 100% coverage after deductible if the treatment is received outside US & Canada. In USA the plan pays (After deductible) 90% In PPO up to US $5,000 and then 100% up to policy maximum. Coverage includes Emergency evacuation, repatriation, choice of deductibles & policy limits.

Who the plan designed for?

  • Graduating seniors trips
  • College students studying abroad
  • Foreign au pairs and nannies
  • Families sponsoring exchange students
  • International vacationers
  • Relatives visiting from overseas
  • Recently arrived immigrants
Read More
  • Short-term travel medical coverage
  • Coverage for individuals, groups and dependents
  • Two plan designs - one for U.S. citizens and one for non-U.S. citizens traveling outside their home country
  • Maximum Limits from $50,000 to $2,000,000
  • Deductible options from $0 to $2,500
  • Walk in Clinic Co-pay/Urgent Care Co-pay: $15/$25
  • Renewable up to 24 months if one month or more are purchased
  • Freedom to seek treatment with hospital or doctor of your choice
PLAN INFORMATION
Maximum Limit Per Period of Coverage Options $50,000, $100,000, $500,000, $1,000,000, $2,000,000 (Patriot International only)
Individual Deductible options $0, $100, $250, $500, $1,000, $2,500
Hospital Room and Board Average semi-private room rate up to the maximum limit. Includes nursing service
Surgery Up to the maximum limit
Intensive Care Up to the maximum limit
Physician Visits Up to the maximum limit
Diagnostic Procedures Up to the maximum limit
Prescription Medication Up to the maximum limit
Home Health Care Up to the maximum limit
Durable Medical Equipment Up to the maximum limit
Emergency Local Ambulance Up to the maximum limit
Emergency Dental Treatment $300 maximum limit due to dental accident or unexpected pain to sound natural teeth
Traumatic Dental Injury
Treatment at a hospital due to an accident
Up to the period of coverage maximum limit
Subject to deductible and coinsurance
Additional treatment for the same injury rendered by a dental provider will be paid at 100%
Emergency Medical Evacuation
Must be approved in advance and coordinated by the company
$1,000,000 maximum limit. Not subject to deductible.
Emergency Reunion
Must be approved in advance by the company
$50,000 maximum limit. Not subject to deductible.
Return of Minor Children
Must be approved in advance by the company
$50,000 maximum limit. Not subject to deductible.
Return of Mortal Remains or Cremation/Burial
Must be approved in advance by the company
$50,000 maximum limit for return of mortal remains or ashes to country of residence, or $5,000 maximum limit for cremation or local burial at the place of death. Not subject to deductible.
Political Evacuation
Must be approved in advance by the company
$10,000 maximum limit. Not subject to deductible.
Natural Disaster $250 per day and maximum limit of five days for accommodations. Not subject to deductible.
Accidental Death and Dismemberment $25,000 principal sum. Not subject to deductible
Common Carrier Accidental Death $50,000 per insured person, $250,000 maximum limit per lifetime per family. Not subject to deductible.
Trip Interruption $5,000 maximum limit. Not subject to deductible.
Lost Luggage $50 per item, $250 maximum limit. Not subject to deductible.
Identity Theft $500 maximum limit. Not subject to deductible.
Hospital Indemnity $100 per overnight inpatient confinement, maximum limit of 10 overnights. Not subject to deductible.
Terrorism $50,000 maximum limit. Not subject to deductible.
Incidental Trips to Home Country
Insured person’s country of residence is not the U.S.
14 consecutive days maximum limit
Incidental Emergency Coverage in the U.S. (Patriot International Only) 14 consecutive days maximum limit. Available only for a covered emergency medical evacuation, or an emergency injury or illness that manifested during travel through the United States to or from the host country.
Coinsurance - for treatment received outside of the U.S. No coinsurance (0%)
Coinsurance - for treatment received within the U.S. In the PPO network - Company pays 100%
Out of the PPO network - Company pays 80% of eligible expenses up to $5,000, then 100%
Pre-Certification Fifty percent (50%) reduction of eligible medical expenses if pre-certification provisions are not met.
Acute Onset of a Pre-existing Condition (Patriot International Only) U.S. citizen up to age 65 with primary health plan: Up to maximum limit.
U.S. citizen up to age 65 without primary health plan: $20,000 maximum limit.
U.S. citizen age 65 to age 70: $2,500 maximum limit.
Non-U.S. citizen up to age 70: Up to maximum limit or $500,000 - whichever is lower.
Acute Onset of a Pre-existing Condition - Emergency Medical Evacuation (Patriot International Only) Up to age 65: $25,000 maximum limit
Urgent Care $25 co-pay. Co-pay is not applicable when the $0 deductible is selected.
Not subject to deductible
Walk-in Clinic $15 co-pay. Co-pay is not applicable when the $0 deductible is selected.
Not subject to deductible
Physical Therapy
Medical order or treatment plan required
Up to the maximum limit
Hospital Emergency Room: International Deductible waived
Hospital Emergency Room: United States Injury not subject to emergency room deductible
Illness: Subject to a $250 deductible for each emergency room visit for treatment that does not result in direct inpatient hospital admission
Interfacility Ambulance Transfer
Transfer from one licensed health care facility to another licensed facility resulting in an inpatient hospital admission
Company pays 100%
Personal Liability
Secondary to any other insurance
Injury to a third person: $100 per injury deductible
Damage to a third person’s property: $100 per damage deductible
No coverage for injury to a related third party or damage to related third person’s property

Patriot Group International provides coverage for U.S. citizens traveling abroad for a minimum of five days up to a maximum of two years. If the plan is purchased for a minimum of one month, coverage may be renewed (without break in coverage) for a total of up to two years. If you or other family members applying for coverage are age 65 or older, please see the Eligibility section in the brochure for additional information.

Options : Other lower and Higher deductible options available as following to improve the deductible or reduced the cost. please use this rate factors.
Deductible Rate Factors. Deductible Rate Factors.
US $ Zero 1.25 US $500 0.90
US $100 1.10 US $1,000 0.80
US $250 1.00 US $2,500 0.70

All premium rates are in U.S. dollars. Rates include surplus lines tax where applicable. A dependent child is your child shown on the Application Form over 14 days and under 18 years of age, traveling with you, and for whom premium has been paid. The following rates are on base of $250 deductible in all the policy maximum options

POLICY LIMIT $50,000 $100,000 $500,000 $1,000,000 $2,000,000
AGE Monthly Rates
18-29 $20.70 $26.10 $30.60 $33.30 $35.10
30-39 $25.20 $30.60 $37.80 $39.60 $41.40
40-49 $42.30 $49.50 $56.70 $56.70 $59.40
50-59 $73.80 $81.90 $86.40 $88.20 $92.70
60-64 $89.10 $97.20 $105.30 $106.20 $111.60
65-69 $107.10 $114.30 $131.40 $142.20 $149.40
70-79 $156.60 N/A N/A N/A N/A
80+* $277.20 N/A N/A N/A N/A
DEP. CHILD $18.90 $23.40 $27.90 $30.60 $34.20
CHILDALONE $20.70 $26.10 $30.60 $33.30 $35.10

POLICY LIMIT $50,000 $100,000 $500,000 $1,000,000 $2,000,000
AGE Daily Rates (Minimum length of coverage is 10 days)
18-29 $0.69 $0.86 $0.99 $1.10 $1.16
30-39 $0.82 $0.99 $1.25 $1.31 $1.36
40-49 $1.38 $1.62 $1.85 $1.86 $1.95
50-59 $2.43 $2.68 $2.84 $2.90 $3.05
60-64 $2.93 $3.20 $3.46 $3.49 $3.66
65-69 $3.51 $3.74 $4.32 $4.66 $4.89
70-79 $5.13 N/A N/A N/A N/A
80+* $9.10 N/A N/A N/A N/A
DEP. CHILD $0.63 $0.77 $0.90 $0.99 $1.13
CHILDALONE $0.69 $0.86 $0.99 $1.10 $1.16

Patriot Group America provides coverage for non-U.S. citizens traveling outside their home country for a minimum of five days up to a maximum of two years. If the plan is purchased for a minimum of one month, coverage may be renewed (without break in coverage) for a total of up to two years. If you or other family members applying for coverage are age 65 or older, please see the Eligibility section in the brochure for additional information.

Options : Other lower and Higher deductible options available as following to improve the deductible or reduced the cost. please use this rate factors.
Deductible Rate Factors. Deductible Rate Factors.
US $ Zero 1.25 US $500 0.90
US $100 1.10 US $1,000 0.80
US $250 1.00 US $2,500 0.70

All premium rates are in U.S. dollars. Rates include surplus lines tax where applicable. A dependent child is your child shown on the Application Form over 14 days and under 18 years of age, traveling with you, and for whom premium has been paid. The following rates are on base of $250 deductible in all the policy maximum options

POLICY LIMIT $50,000 $100,000 $500,000 $1,000,000
AGE Monthly Rates
18-29 $33.00 $42.00 $56.00 $61.00
30-39 $45.00 $60.00 $73.00 $78.00
40-49 $67.00 $83.00 $104.00 $116.00
50-59 $89.00 $113.00 $148.00 $158.00
60-64 $109.00 $142.00 $194.00 $207.00
65-69 $129.00 $165.00 $220.00 $240.00
70-79 $176.00 N/A N/A N/A
80+* $313.00 N/A N/A N/A
DEP. CHILD $32.00 $38.00 $49.00 $54.00
CHILD ALONE $33.00 $42.00 $56.00 $61.00

POLICY LIMIT $50,000 $100,000 $500,000 $1,000,000
AGE Daily Rates (Minimum length of coverage is 10 days)
18-29 $1.10 $1.40 $1.87 $2.03
30-39 $1.50 $2.00 $2.43 $2.60
40-49 $2.23 $2.77 $3.47 $3.87
50-59 $2.97 $3.77 $4.93 $5.27
60-64 $3.63 $4.73 $6.47 $6.90
65-69 $4.30 $5.50 $7.33 $8.00
70-79 $5.87 N/A N/A N/A
80+* $10.43 N/A N/A N/A
DEP. CHILD $1.07 $1.27 $1.63 $1.80
CHILD ALONE $1.10 $1.40 $1.87 $2.03

* $10,000 Maximum

Quality Guarantee

The group's satisfaction is very important to IMG and the plan underwriter. If the sponsoring organization or group is not pleased with this product for any reason, a written request, prior to the effective date, for cancellation and refund of the premium. If the group does not have any claims filed with IMG, you may cancel your plan after your effective date, however, the following conditions will apply: 1) you will be required to pay a $50 cancellation fee and 2) only full month premiums will be considered for refunds (e.g., if you choose to cancel your coverage two months and two weeks prior to the date your coverage ends, IMG will only consider the two full months for a refund). If you have filed claims, your premium is non-refundable.

Precertification, Emergency Evacuation and Repatriation

For precertification, emergency evacuation and repatriation, please call: IMG in the US: 1-800-628-4664 (toll free) or 1-317- 655-4500. Call IMG outside the US: 001-317-655-4500 (collect if necessary). This information will also be provided on your ID card.

IMG must be notified prior to treatment or within 48 hours of an emergency.

To Report Claims

Please mail completed claim forms to International Medical Group, P.O. Box 88500, Indianapolis, IN 46208-0500 USA. All IMG contact numbers, claim forms and Certificate Wordings will be included in the fulfillment kit. IMG may also be contacted by fax: 317- 655-4505 or e-mail: insurance@imglobal.com