This plan is provided by Cultural Insurance Services International
and underwritten by Ace American Insurance Company
Please note: To enroll through the John Cabot Insurance Policy, you must enroll on this page.
| Coverages and Services | Maximum Limits |
|---|---|
| Accidental Death & Dismemberment: | |
|
Per Insured |
$10,000 |
|
Aggregate Limit Per Accident |
$1,000,000 |
| Medical Expense (per Accident or Sickness): | |
| Deductible | $35.00 |
| Basic Medical | $200,000 @100% |
| Accidental Dental | 100% of Covered Expenses, up to policy limits |
| Dental Relief of Pain | $500 max/$250 per tooth |
| Pre-existing Conditions Coverage Limit | 100% up to the first $5,000, secondary up to $10,000 |
| Mental and Nervous | Inpatient up to $5,000, Outpatient up to $2,500 |
| Prescription Drugs (Inpatient/Outpatient) | 100% |
| Maternity | Covered |
| Physiotherapy | If recommended by a Physician and administered by a licensed physiotherapist |
| Specified Therapies and Spinal Manipulation, including acupuncture and physiotherapy: | |
| Outpatient Limit | Max of $50/visit; maximum of 10 visits; $500 overall maximum |
| Emergency Medical Evacuation | $100,000 |
| Repatriation/Return of Mortal Remains | $50,000 |
| Security Evacuation Comprehensive | $100,000 ($1M aggregate limit) |
| Emergency Medical Reunion | $3,000 ($300/day,10 day max) Hospitalized after 5 days |
| Trip Delay | $500/12 Hours/$100 per day limit |
| Trip Interruption | Up to $1,000 |
| 24/7 Team Assist Package & CISI Crisis Team | Included |
Please contact the Team Assist line by phone at +1 312-935-1703 (collect calls accepted) or email medassist-usa@axa-assistance.us. The TeamAssist Emergency Assistance Provider is AXA Assistance.
Non-Emergency questions may be directed to CISI at 203-399-5130 (toll free 800-303-8120).
To seek recommendations for doctors or hospitals, please contact Team Assist at +1 312-935-1703 or email medassist-usa@axa-assistance.us. *We can make appointments for you.
For outpatient services, the insured will need to pay for the services at the time of the visit. For eligible reimbursements, after your visit, please submit the itemized bill and completed claim from to claimhelp@mycisi.com for review. The average turnaround time for reimbursement is 2 weeks from receipt of claim information.
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