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.



Medical Evacuation & Repatriation

Any student under the PSI Silver, Gold, Platinum or Diamond Plan are eligible for global emergency and medical assistance services provided by UnitedHealthcare Global. These benefits are available if you are traveling 100 miles or more from your permanent home, campus address, or while you are abroad. These services are accessible 24 hours a day, 365 days a year!

Sometimes while traveling you may feel “if it can go wrong, it will go wrong with me”. With this service, you have a caring partner to provide peace of mind for all issues that may occur while traveling. UnitedHealthcare Global is committed to resolve emergencies by doing whatever it takes…their goal is to save lives and solve problems!

One phone call to UnitedHealthcare Global connects you to:
  • A state-of-the-art Emergency Response Center with worldwide response capabilities
  • Experienced crisis management professionals
  • A global network of over 41,000 pre-qualified medical providers
  • Air and ground ambulance service providers


To learn more about this valuable benefit, review the UHCG Program Guide

There are many services provided by this program, below is just a sample of what is offered:

Program Summary

Worldwide Medical and Dental Referrals

We will provide referrals to help you locate appropriate treatment and quality care.

Facilitation of Hospital Admittance Payments

We will issue a prompt financial guarantee (or wire funds) up to five thousand dollars ($5,000) to facilitate admittance to a foreign (non-US) medical facility. To the extent additional funds are required; we will issue a prompt financial guarantee (or wire funds) to facilitate admittance upon securing such funds from you, your family, or your friends via wire transfer or credit card(s). You are ultimately responsible for the payment of the cost of medical care and treatment, including hospital expenses.

Dispatch of Doctors/Specialists

In an emergency where we determine that you cannot adequately be assessed by telephone for possible evacuation from your initial medical facility, or you cannot be moved and local treatment is unavailable, we will endeavor to send an appropriate medical practitioner to you when we deem it appropriate for medical management of a case. We will pay for the transportation and related expenses of the medical practitioner. You are responsible for the payment of the cost of medical care and treatment.

Transfer of Medical Records

Upon your consent, we will assist with the transfer of medical information and records to you or the treating physician.

Updates to Family, Employer, and Home Physician

With your approval, we will provide periodic case updates to appropriate individuals you designate in order to keep them informed.

Hotel Arrangements for Convalescence

We will assist you with the arrangement of hotel stays and room requirements before or after hospitalization for ongoing care. You are responsible for costs of lodging and incidental expenses.

Emergency Medical Evacuation

If you sustain an injury or illness, that in the opinion of UnitedHealthcare Global and the treating healthcare provider, requires urgent medical attention and adequate medical treatment is not available at your initial medical facility, we will arrange and pay for a medically supervised evacuation to the nearest medical facility we determine to be capable of providing appropriate medical treatment. Your medical condition and situation must be such that, in the professional opinion of the health care provider and UnitedHealthcare Global, you require immediate emergency medical treatment, without which there would be a significant risk of death or serious impairment. All such arrangements must be coordinated and approved in advance by us.

Transportation to Join a Hospitalized Participant

If you are traveling alone and are or will be hospitalized for more than three (3) days due to an illness or injury, we will coordinate and pay for economy round-trip airfare for a person of your choice to join you. We will also assist with the arrangement of their hotel stay during your hospitalization. Costs of lodging, meals, and incidental expenses are the responsibility of the traveler.

Return of Minor Children

If your minor child(ren) age 18 or under are present but left unattended as a result of your injury or illness, we will coordinate and pay for one-way economy airfare (or upgraded transportation to match your originally booked travel) to send them back to your home country. We will also arrange and pay for the services, transportation expenses, and required accommodations of a non-medical escort, if required and as determined by UnitedHealthcare Global.

Repatriation of Mortal Remains

In the event of your death, we will assist in obtaining the necessary clearances for your cremation or the return of your mortal remains. We will coordinate and pay for commercially reasonable efforts for the expenses of the preparation and transportation of your mortal remains to your home country or place of primary residence, as well as obtain and pay for the number of certified death certificates required by the Host Country and home country to release and receive the remains.

Replacement of Lost or Stolen Travel Documents

We will assist you in taking the necessary steps to replace passports, tickets, and other important travel documents.

Transfer of Funds

We will provide you with an emergency cash advance subject to us first securing funds from you or your family. You are responsible for any fees for the wiring of these funds.

Legal Referrals

Should you require legal assistance, we will direct you to an attorney.

Message Transmittals

You may send and receive emergency messages toll-free, 24-hours a day, through our Emergency Response Center.

IMPORTANT: Insureds must call UnitedHealthcare Global first in order to activate this benefit. UnitedHealthcare Global does not reimburse monies spent for services not dispatched and rendered by UnitedHealthcare Global.

To access services please call:

(800) 527-0218 Toll-free within the United States

(410) 453-6330 Collect outside the United States

Services are also accessible via e-mail at operations@unitedhealthcareglobal.com

When calling the UnitedHealthcare Global Operations Center, please be prepared to provide:

  • Caller’s name, telephone and (if possible) fax number, and relationship to the patient;
  • Patient’s name, age, sex, and UnitedHealthcare Global ID Number as listed on your Medical ID Card;
  • Description of the patient’s condition;
  • Name, location, and telephone number of hospital, if applicable;
  • Name and telephone number of the attending physician;
  • Information of where the physician can be immediately reached


UnitedHealthcare Global is not travel or medical insurance but a service provider for emergency medical assistance services. All medical costs incurred should be submitted to your health plan and are subject to the policy limits of your health coverage. All assistance services must be arranged and provided by UnitedHealthcare Global. Claims for reimbursement of services not provided by UnitedHealthcare Global will not be accepted.