Clayton State University


World Class Coverage Plan Designed For Clayton State University

This plan is provided by Cultural Insurance Services International
and underwritten by Ace American Insurance Company, a member of the
Chubb Group of Companies

Coverage Summary for Policy # GLM N10892880

Coverages and Services Maximum Limits
Section I
Accidental Death and Dismemberment Per Insured:
Faculty/Student $10,000
Spouse $25,000
Per Child $5,000
Medical expenses (per Accident or Sickness)
Deductible $0
Basic Medical $500,000 at 100%
Extension of Benefits 30 days
Emergency Medical Reunion
(incl. hotel/meals, max $150/day)
Home Country Coverage Limit $10,000
Program Fee Refund (Student Only) $5,000
Quarantine (Applicable only to Insureds whose coverage starts on or after November 23, 2021) $2,000
Return of Minor Child(ren) $2,500
Trip Interruption $1,000
Trip Delay $500 ($100/day)
Lost Checked Baggage (deduct. $50, $100/item) $250max
Section II
Emergency Medical Evacuation
100% of Covered Expenses
Participants in Antarctica $250,000 max
Repatriation/Return of Mortal Remains
100% of Covered Expenses
Participants in Antarctica $250,000 max
Security Evacuation (Comprehensive)*
    * Aggregate of $2.5M

Please contact the Team Assist line by phone at 312-935-1703 (collect calls accepted) or email . The TeamAssist Emergency Assistance Provider is AXA Assistance Non-Emergency questions may be directed to CISI at (203) 399-5132 (toll free 800-303-8120).

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