=*=+=*=+=*=+=*=+=* INTERNATIONAL COMMUNITY SERVICE *=+=*=+=*=+=*=+*=+=*= A nonprofit, nonpolitical, voluntary service organization registered in USA exclusively for educational/scientific/charitable purposes, ICS is dedicated to promoting international exchange as well as to serving the international students/scholars community. ........................................................................ info@icsweb.org http://www.icsweb.org ........................................................................ ICS News Release Special ICS Health Insurance Program (PLAN A, VANTAGE PLAN, DISCOUNT PLAN) 2010-2011 ..............................INTRODUCTION.............................. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Dear Students/Scholars: Greetings from International Community Service (ICS)! We are pleased to introduce the ICS Health Insurance Program. The policies for 2010-2011 school year retain the same distinctive features (i.e., low rates, high benefits, and comprehensive coverage) that have over the years become most popular among international students/scholars. ICS plans have served students/scholars and families at 300+ colleges/universities across USA since 1995. As a tradition, ICS has always enjoyed working with campus organizations to best serve the needs of their members and beyond. We would gratefully appreciate your assistance in distributing ICS info to Students/Scholars in your school or local area (e.g., post this release to your email lists and websites, or link ICS website). Included below are some highlights for your consideration. Enrollment Form is attached at the end for your convenience. Please visit ICS website for online enrollment and related info (brochures, forms, etc.). Sincerely, (Signed) INTERNATIONAL COMMUNITY SERVICE ------------------------------------------------------------------------- Email: info@icsweb.org WebSite: http://www.icsweb.org/ Toll Free: 1-800-356-1235 [English, 8:00-5:00 EDT Mon-Fri] Fax: 1-954-772-0872 [For enrollment, compliance forms, etc.] ------------------------------------------------------------------------- >Some highlights of the 2010-2011 ICS PLANs [Please read ICS brochures/certificates for more details] ELIGIBILITY 1) All Students/Scholars (from all parts of the world) with valid non-immigration visas (F-1, J-1, etc.), including Students on practical training or temporary vacation. 2) Legal dependents - Spouse and unmarried Children under age 19 (may not enroll unless the principal Student/Scholar is also enrolled). 3) Individuals with dependent visas (F-2, J-2, etc.), who are normally considered dependents, may enroll independently (at the Student/Scholar rate) if enrolled in legitimate classes at a US college (including community colleges) or university for at least six (6) credit hours in a semester/quarter. PREMIUM RATES Student/Scholar Spouse Child Age Annual Monthly* Annual Monthly* Annual Monthly* Plan A 0-30 $ 864 $ 72 $3,552 $ 296 $1,584 $ 132 31-40 $1,104 $ 92 $4,416 $ 368 $1,584 $ 132 41-100 $1,344 $ 112 $5,328 $ 444 $1,584 $ 132 Vantage Plan 0-24 $ 624 $ 52 $2,532 $ 211 $1,320 $ 110 25-30 $ 888 $ 74 $3,636 $ 303 $1,320 $ 110 31-40 $1,284 $ 107 $5,088 $ 424 $1,320 $ 110 41-100 $2,472 $ 206 $9,852 $ 821 $1,320 $ 110 Discount Plan 0-24 $ 420 $ 35 $1,632 $ 136 $ 984 $ 82 25-30 $ 492 $ 41 $1,920 $ 160 $ 984 $ 82 31-40 $ 876 $ 73 $3,432 $ 286 $ 984 $ 82 41-50 $1,236 $ 103 $4,848 $ 404 $ 984 $ 82 51-100 $2,496 $ 208 $9,600 $ 800 $ 984 $ 82 *Minimum Enrollment of 3 Months COMPREHENSIVE COVERAGES Covered Medical Expenses (Injury/Sickness): Inpatient/Outpatient, plus: Medical Emergency; Prescription Drugs; Elective Abortion; Maternity (conception must occur after the Insured's effective date of coverage); Child Coverage; Mammographic Exams; Repatriation; Medical Evacuation; Accidental Death & Dismemberment (AD&D); Psychotherapy (Mental or Nervous Disorders, Alcoholism, or Drug Abuse); etc. [Please refer to ICS brochures/certificates for Policy details.] Covered Medical Expenses* PLAN A VANTAGE PLAN DISCOUNT PLAN (Per Injury or Sickness) $ 0.01 - $ 2,500.00** 100% 80% 80% $ 2,500.01 - $ 5,000.00 80% 80% 80% $ 5,000.01 - $ 7,500.00 80% 80% 80% $ 7,500.01 - $ 10,000.00 80% 80% 80% $ 10,000.01 - $ 35,000.00 80% 80% 80% $ 35,000.01 - $ 50,000.00 80% 80% 100% $ 50,000.01 - $100,000.00 100% 80% 100% $100,000.01 - $250,000.00 100% 80% N/A * Coinsurance percentage is for "In-PPO" expenses; benefits are reduced if outside of PPO. Benefits are subject to all applicable policy terms and conditions (including restrictions and limitations). ** The Insured is responsible for a Per Injury/Sickness Deductible of Covered Medical Expenses as follows. Deductible At SHC* In PPO Out PPO Plan A $ 50 $ 100 $ 200 Vantage Plan $ 50 $ 100 $ 100 Discount Plan $ 0 $ 0 $ 0 *SHC = Student Health Center (or Infirmary) >Attached ..................................Cut Here................................. International Community Service Enrollment Form for Student/Scholar Accident & Health Insurance 2010-2011 ================================================= Please Print All Applicable Information Clearly - Failure to do so may delay or void your insurance ================================================= [Please refer to ICS brochures for Policy details] Last Name: First Name & MI: Address: City: State & Zip: Social Security No. (or Student ID): Date of Birth (mm/dd/yyyy): Gender (Male or Female): Telephone (include area code): Fax (include area code): Email: Status (Student, Scholar, or ICS Member): Visa Type (F-1, J-1, etc.): School Advisor's Name (Last/First): College or University Attending: CIN # (leave blank if unknown): Home Country (Country of Origin): Indicate Period/Coverage Selected - Period (Annual; 11, 10, ... 3 Months Minimum): Plan (Plan A, Vantage Plan, Discount Plan, etc.): Desired Starting Date (mm/dd/yyyy): Specify "New Application" or "Renewal": List All Dependent(s) To Be Insured - Spouse Name (Last/First): Spouse Birth Date (mm/dd/yyyy): Spouse Gender (Male or Female): Child_1 Name (Last/First): Child_1 Birth Date (mm/dd/yyyy): Child_1 Gender (Male or Female): Child_2 Name (Last/First): Child_2 Birth Date (mm/dd/yyyy): Child_2 Gender (Male or Female): Child_3 Name (Last/First): Child_3 Birth Date (mm/dd/yyyy): Child_3 Gender (Male or Female): Credit Card Payment Authorization - Card Type (MasterCard/VISA/Discover/American Express): Cardholder's Name (Last/First): Card No.: Card Expiration Date (mo/yr): Total Premium to be charged: $ ..................................Cut Here................................. Submit completed application (Enrollment Form + Premium Payment): By Mail: Insurance for Students 600 Corporate Drive, Suite 101 Ft. Lauderdale, FL 33334 By Fax (Credit Card Payment Authorization required): Insurance for Students 1-954-772-0872 (fax) By Email: enroll@icsweb.org (For Enrollments Only) [For assistance, please contact Insurance for Students at 1-800-356-1235] ___________________________________________________________________________ $THE END$