ISP Sports Plus

 

Eligibility:

All international students, scholars or other persons with a current passport who: 1) are engaged in educational activities; and 2) are temporarily located outside his/her home country as a non resident alien; and 3) have not obtained permanent residency status in the U.S. are eligible to enroll in this plan. Those enrolled in an English language or similar program or an Optional Practical Training Program or with an For J visa are also eligible to enroll in the plan. Eligible Dependents of those enrolled in the plan may participate on a voluntary basis. The named insured must actively attend classes tor at least the first 31 days after the date for which coverage is purchased with the exception of those with a J visa or those engage in an Optional Practical Training Program.

Rate per 30 Days (Deductible $100/$500)

$159.30

Rate per 30 Days (Deductible $500/$750)

$143.10

 

Benefits Coverage
Maximum Benefit Limit per Sickness or Injury Unlimited
Maximum for Intercollegiate Sports $10,000
Deductible per person (In Network)

Option of $100 per policy year or

$500 per policy year

Coinsurance 80% in Network/ 60% Out of Network
Out of Pocket Maximum (In Network) $6,350/ $12,700
Prescription Drugs

$15 for Tier 1                          

25% Coinsurance Tier 2  

40% Coinsurance for Tier 3

Preventative Care

100% of Preferred Allowance                              

In Network Only                  

No Cap

Physician Visits $25 Copay
Medical Emergency $200 Copay
Pre-Existing Condition N/A
Evacuation/Repatriation No Maximum
Nurse Hotline Included

ISP Plus Sports Summary Brochure