Health Insurance designed for the International Students of the THE TEXAS A&M UNIVERSITY SYSTEM 2011-2012

1. Health Insurance designed for the International Students of theTHE TEXAS A&M UNIVERSITY SYSTEM2011-2012 Underwritten By: Companion Life Insurance Company (A+) Administered by: Associated Insurance Plans International, Inc. (AIP) Serviced By: Dunlap Financial Services, College Station www.TAMUInsurance.com 800-452-5772

2. Student Health InsuranceWe’ve got you covered! All International Students attending TAMU-College Station will be insured under the A&M 200K International Student Insurance Plan. • Fall Semester Coverage provided to midnight on December 31, 2011. • Spring/Summer Semester Coverage provided to midnight on August 16, 2012. • Benefits are provided 24 hours each day, anywhere in the world. www.TAMUInsurance.com 800-452-5772

3. Some “insurance terms” you need to know • Preferred Provider – An organization where providers are under contract to an insurance company or health plan to provide care at a discounted or negotiated rate. • Deductible – a specified amount the insured must pay before the insurance company begins to make any payments to your providers for medical treatment. • Co-Insurance – a specified percentage the insured is required to pay for all covered medical expenses remaining after the deductible has been met. • Co-Pay – a specified amount the insured must pay towards medical treatment or prescriptions. • Pre-Existing Condition - A health insurance policy provision stating that benefits will not be paid for any illness and/or condition that existed prior to one becoming an insured under the particular health plan in question, until the insured has been covered under the policy for a specified period. www.TAMUInsurance.com 800-452-5772

4. Preferred Providers • 1. A.P. Beutel Student Health Center - 100% reimbursement for covered medical expenses treated at the Health Center. • 2. PHCS National Preferred Provider Network - 80% reimbursement for Network treatment. • 3. Beech Street National Preferred Provider Network - 80% reimbursement for Network treatment. • 60% reimbursement for out-of-Network treatment. • Outside the United States the Preferred Providers are not available, but benefits will be reimbursed at 80%. www.TAMUInsurance.com 800-452-5772

5. Deductible • $250 each plan year ($500 for family) NOTE: The deductible is always waived for medical treatment received at A.P. Beutel Student Health Center. www.TAMUInsurance.com 800-452-572

6. Co-pays • Outpatient Physician visit $25 plus 20%/40% of the remaining charges • Urgent Care Treatment Center: $25 plus 20%/40% of the remaining charges • Emergency Room (ER) visit: $250 plus 20%/40% of the remaining charges www.TAMUInsurance.com 800-452-5772

7. Co-pays and Pharmacy At the Student Health Center • $15 co-pay per 30 day supply (paid at 100% to $500 per policy year). • Prescription Drug Card: cost of prescription medication to $1,000 per policy year, subject to a co-payment per 30 day supply. Co-pays: • $15 co-pay for generic • $25 co-pay for brand • $35 co-pay for single source (Contraceptives are included.) www.TAMUInsurance.com 800-452-5772

8. Additional Benefits • Accidental Death & Dismemberment: $5,000 • Repatriation of mortal remains: $15,000 for International students • Medical Evacuation: up to $25,000 (advance approval required) • Travel Assistance: Referrals to the nearest most appropriate facilities and providers - with guarantees of payment to providers, and assistance in coordinating insurance benefits. • 24 hour Nurse Advice Line www.TAMUInsurance.com 800-452-5772

9. Maximum Benefit • $200,000 per condition www.TAMUInsurance.com 800-452-5772

10. Policy Limitations www.TAMUInsurance.com 800-452-5772 Note: This policy provides benefits for accidents and sicknesses. Routine care for “wellness” is not covered. • Pre-existing conditions: • Pre-existing conditions are covered if (1) you are 12 months treatment free from your pre-existing condition; or (2) you have been continuously insured through an insurance plan, or through your country or government for 18 consecutive months prior to enrolling in this TAMU insurance plan; or (3) you have been continuously insured for 12 months under any TAMU student plan. • Exception to pre-existing condition limitation: Maternity • Policy Exclusions: Read your brochure carefully.

11. How do I file a claim? • 1) Secure the necessary medical treatment. • 2) Obtain itemized bills from your doctor or other provider. • 3) Complete a claim form. Make sure you answer all of the questions or your reimbursement may be delayed. • 4) Mail your completed claim form and itemized bills to Administrative Concepts, Inc. 994 Old Eagle School Road, Suite 1005 Wayne, PA 19087-1802 www.TAMUInsurance.com 800-452-5772

12. Options for Dental & Vision Coverage Dental & Vision Insurance Option: • Choice of 3 plans with different • co-insurance options • Choice of $1,000, $1,500 or $2,000 annual maximum benefit • No waiting period • Optional Vision coverage • Premium as low as $20 per month for annual coverage Discount Card Option: • low annual premium for pharmacy, dental, and vision discounts • Participating providers include all major vision and pharmacy chains • No claim forms to complete • Discount is immediate at the time of service www.TAMUInsurance.com 800-452-5772

13. Information Available At: www.TAMUInsurance.com • Description of Coverage • Dependent Enrollment Links • Print Identification Card • Preferred Provider Look-up • Claim Forms • Online Claim Status Inquiry • Claim Procedures • Frequently Asked Questions • Student Insurance Survey • Dental and Vision Coverage options 800-452-5772

14. Questions and Assistance Contact AIP for personal attention Monday through Friday, 8:00 a.m. to 7:00 p.m. (CST) (800) 452-5772 or email us through www.TAMUInsurance.com or contact our Representative in College Station (located in the Bank of America building): Dunlap Financial Services (979) 260-9632