| Maple | Maple | Cedar J1 | Cedar J1 | J1 Premier | |
|---|---|---|---|---|---|
| Price/30 days |
$44.40
$500 ded.
|
$44.40
$500 ded.
|
$53.10
$100 ded.
|
$53.10
$100 ded.
|
$64.80
$100 ded.
|
| PPO Network | UnitedHealthcare | Aetna | Aetna | UnitedHealthcare | UnitedHealthcare |
| Maximum Benefit | $100,000 PIS | $100,000 PIS | $100,000 PIS | $100,000 PIS | $500,000 |
| Deductible at SHC | $500 PIS | $500 PIS | $100 PIS | $100 PIS | $100 per illness/injury |
| Co-Insurance | 80% | 80% | 100% | 100% | 80% |
| Physician Visits | $0 copay | $0 Copay | $0 copay | $0 copay | $0 copay |
| Urgent Care | $0 copay | $0 Copay | $0 copay | $0 copay | $0 copay |
| Emergency Room Visits | $250 copay | $250 Copay | $250 copay | $250 copay | $250 copay (waived if admitted) |
| Prescription Drugs | 80% | 80% | 100% | 100% | $20/$40/$60 copay |
| Preventive Care | Not Covered | Not Covered | Not Covered | Not Covered | 100% ($250 Maximum Benefit) |
| Pre-existing Condition | ✓ (after 12 months) | Waiting Period 12 Months | ✓ (after 12 months) | ✓ (after 12 months) | 6 months waiting period |
| Out-of-Pocket Maximum | Unlimited | Unlimited | Unlimited | Unlimited | $6,950 |
| Maternity | Not covered | Not Covered | Not Covered | Not Covered | 80% |
| Mental Health | Not covered | Not Covered | Not Covered | Not Covered | 80% |
| Intramural, Club & Recreational Sports | Not covered | ✘ | ✘ | - | Not Covered |
| Pediatric Dental/Vision | Not covered | ✘ | ✘ | - | Not Covered |
| Medical Evacuation & Repatriation | $50,000 | ✓ ($50,000 Max) | ✓ ($50,000 Max） | ✓ ($50,000 Max） | $50,000 Combined Maximum Benefit |
| Return of Mortal Remains | $25,000 | ✓ ($25,000 Max) | ✓ ($25,000 Max) | ✓ ($25,000 Max) | $25,000 |
| Worldwide Coverage | Worldwide Basis, Excluding Home Country | ✓ (Except Home Country) | ✓ (except Home Country) | ✓ (except Home Country) | ✓ (except Home Country) |