School Term   Freedom Plan 2015-015430-6     Liberty Plan 2015-015430-5     Silver Plan 2015-202822-3     Silver Plan 2016-202822-3  
  24 & Under 25 - 29 30 and above 24 & Under 25 - 29 30 and above 24 & Under 25 - 29 30 and above 24 & Under 25 - 29 30 and above
  ANNUAL 2015-16 $348 $552 $1,068 $468 $684 $1,308 $461 $698 $1,980 - - -
  PER MONTH (30-DAY RATE) $29 $46 $88 $39 $57 $108 $39 $58 $164 - - -
  ANNUAL 2016-17: 07/01/2016 to 06/30/2017 - - - - - - - - - $461 $698 $1,980
  PER MONTH (30-DAY RATE): 07/01/2016 to 07/30/2016 - - - - - - - - - $39 $58 $164
No Lifetime Limits On Benefits No Lifetime Limits On Benefits No Lifetime Limits On Benefits No Lifetime Limits On Benefits
$150,000 per Injury and Sickness $250,000 per Injury and Sickness $500,000 per Injury or Sickness $500,000 per Injury or Sickness
Coinsurance: 100% In-Network, 80% Out-Network Coinsurance: 100% In-Network, 80% Out-Network Coinsurance: 80% In-Network, 70% Out-Network Coinsurance: 80% In-Network, 70% Out-Network
Diagnostic X-rays & Lab Services Diagnostic X-rays & Lab Services Diagnostic Services and Laboratory Tests Diagnostic Services and Laboratory Tests
Mental Illness & Substance Use Disorder Treatment Mental Illness & Substance Use Disorder Treatment Mental Illness & Substance Use Disorder Treatment Mental Illness & Substance Use Disorder Treatment
Prescription Drugs Coverage Included Prescription Drugs Coverage Included Prescription Drugs: 70% up $1,000 max per year Prescription Drugs: 70% up $1,000 max per year
$100 Deductible per Injury or Sickness $90 Deductible per Injury or Sickness Urgent Care Facilities - $50 copay Urgent Care Facilities - $50 copay
24/7 Emergency Assistance Call Center 24/7 Emergency Assistance Call Center Pre-Existing Conditions - Six months waiting period Pre-Existing Conditions - Six months waiting period
Evacuation & Repatriation $60,000 Evacuation & Repatriation $120,000 Evacuation & Repatriation - Pays 100% for services provided Evacuation & Repatriation - Pays 100% for services provided
Review FREEDOM PLAN Policy Brochure Review LIBERTY PLAN Policy Brochure Review SILVER PLAN Policy Brochure Review SILVER PLAN Policy Brochure
All charges shown include premium, credit card transaction fees, ACH processing fees and other cost associated with offering this health plan. The programs offered here are underwritten by Student Resources (SPC) Ltd. A UnitedHealth Group Company. This plan can only be enrolled through www.psiservice.com.



Disclaimer:

"PSI gathered this information as a resource for students, and this does not intend to imply a relationship between your school and our website or company. We advise you to double-check directly with your school to ensure that these Student Plans meet your school's insurance requirements." "We gathered this information as a resource for students, and this does not intend to imply a relationship between your school and our website or company. We advise you to double-check directly with your school to ensure that these Student Plans meet your school's insurance requirements."