F1, J1, F2, J2 visa holders
Who can enroll?

International students who:

1) have vaild F1 and J1 visa status, AND
2) an associate, bachelor, master or Ph.D. or formal university ESL program, and,
3) are currently registered with no less than 6 credit hours* are eligible and qualified to enroll.

The Company maintains its right to investigate student status and attendance records to verify that the policy eligibility requirements have been met.
If and whenever the Company discovers that the policy eligibility have not been met, its only obligation is refund of premium.

*The six credit hour requirement is waived for summer, if the applicant will continue to register as a full time student in the following fall term.
What are the Choice of Plans?

Under each premium rates table, you can Review the Policy Brochure for every plan in detail. The Diamond Plan has the most expensive benefits of all four plans, followed by the Platinum Plan, then the Gold Plan, and finally the Silver Plan. You cannot upgrade benefit coverage after your initial purchase of the plan for this policy year. Please be aware that if you choose to upgrade coverage in any subsequent policy year, a new Pre-existing Condition exclusion and waiting period will apply.



2015-16 PSI Freedom Plan Annual Maximum $400,000
Up to $150,000 Per Injury or Sickness
No Lifetime Limits of Benefits
Medical Evacuation $60,000 / Repatriation $50,000
100% Co-insurance*
Policy Number 2015-015430-6
$100 Deductible per Injury or Sickness
Age Group Monthly Annual
12 to 24 $29 $348
25 - 29 $46 $552
30 to 65 $89 $1,068
Spouse & Child $189 $2,268
* Refer to the accident & sickness benefit description for per event and daily limits.



2015-16 PSI Liberty Plan Annual Maximum $600,000
Up to $250,000 Per Injury or Sickness
No Lifetime Limits of Benefits
Medical Evacuation - $120,000 / Repatriation - $60,000
100% Co-insurance*
Policy Number 2015-015430-5
$90 Deductible per Injury or Sickness
Age Group Monthly Annual
12 to 24 $39 $468
25 - 29 $57 $684
30 to 65 $109 $1,308
Spouse & Child $229 $3,588
* Refer to the accident & sickness benefit description for per event and daily limits.



2015-16 PSI SILVER PLAN Up to $500,000 Per Injury or Sickness Maximum Benefit
No Lifetime Limits on Benefits
Includes Medical Evacuation & Repatriation
Policy Number 2015-202822-1 2015-202822-3
$0 Deductible $500 Deductible
Age Group 30-Days Annual 30-Days Annual
24 & Under $45.00 $544.00 $38.10 $461.00
25 - 29 $67.20 $818.00 $57.30 $698.00
30 & Above $184.50 $2,242.00 $163.20 $1,980.00
Spouse $501.30 $6,094.00 $435.90 $5,304.00
Child $111.30 $1,305.00 $93.90 $1,138.00
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.



2015-16 PSI GOLD PLAN Up to $1,000,000 Per Insured Person, Per Policy Year Maximum Benefit
No Lifetime Limits on Benefits
Includes Medical Evacuation & Repatriation
Policy Number 2015-202820-1 2015-202820-3
$0 Deductible $500 Deductible
Age Group 30-Days Annual 30-Days Annual
24 & Under $53.70 $650.00 $44.70 $540.00
25 - 29 $88.80 $1080.00 $73.50 $847.00
30 & Above $222.30 $2,700 $187.50 $2,280.00
Spouse $573.60 $6,978.00 $478.20 $5,817.00
Child $127.50 $1,550.00 $108.30 $1,317.00
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.



2015-16 PSI PLATINUM PLAN No Overall Maximum Dollar Limit Per Insured Person, Per Policy Year
Includes Medical Evacuation & Repatriation
Policy Number 2015-202819-1 2015-202819-3 2015-202819-4
$0 Deductible $500 Deductible $1500 Deductible
Age Group 30-Days Annual 30-Days Annual 30-Days Annual
24 & Under $76.50 $928.00 $68.10 $828.00 $58.50 $708.00
25 - 29 $129.60 $1,573.00 $108.90 $1,320.00 $99.00 $1,200.00
30 & Above $336.60 $4,092.00 $265.60 $3,240.00 $240.00 $2,916.00
Spouse $789.30 $9,600.00 $661.20 $8,045.00 $595.50 $7,242.00
Child $173.40 $2,108.00 $146.70 $1,782.00 $132.00 $1,606.00
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.



2015-16 PSI DIAMOND PLAN No Overall Maximum Dollar Limit Per Insured Person, Per Policy Year
Includes Medical Evacuation & Repatriation
Policy Number 2015-202821-1 2015-202821-3
$0 Deductible $500 Deductible
Age Group 30-Days Annual 30-Days Annual
24 & Under $153.90 $1,866.00 $130.50 $1,585.00
25 - 29 $178.50 $2,170.00 $148.80 $1,809.00
30 & Above $315.90 $3,840.00 $264.60 $3,216.00
Spouse $584.70 $7,111.00 $486.60 $5,918.00
Child $219.90 $2,673.00 $186.30 $2,263.00
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.



2015-16 SHORT-TERM PLAN Up to $250,000 Per Injury or Sickness Maximum Benefit
Includes Medical Evacuation & Repatriation
Offered only to PSI Customers insured for at least 3 consecutive months under PSI Student Plans
Policy Number 2015-202852-1
$500 Deductible Per Insured, Per Policy Year
Age Group 30-Days 6 Months of Coverage Maximum
24 & Under $61.80 $749.00
25 - 29 $92.40 $1,118.00
30 & Above $241.80 $2,939.00
Spouse $657.90 $8,004.00
Child $140.70 $1,708.00
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.



2015-16 GOLD HIGH SCHOOL PLAN $1,000,000 Per Insured Person, Per Policy Year Maximum Benefit
Includes Medical Evacuation & Repatriation
Policy Number 2015-202897-2
$0 Deductible
30-Days Annual
High School Student $57.60 $696.00
 
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.



2015-16 PLATINUM HIGH SCHOOL PLAN No Overall Maximum Dollar Limit Per Insured Person, Per Policy Year
Includes Medical Evacuation & Repatriation
Policy Number 2015-202897-1
$0 Deductible
30-Days Annual
High School Student $81.00 $980.00
 
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.