Pioneer Elite 10K

The Pioneer Elite plan is designed with intercollegiate athletes in mind, as it provides benefits for accidents and sicknesses that occur while participating in intercollegiate sports.  

The Pioneer Elite plan is ISP’s high-end program, which meets J-1 state department visa requirements and most university waiver requirements.

The Pioneer Elite is not available in all states or to all schools. Plan design may vary on a state by state basis.

  • Sports Limit of $10,000
    Reduced Copayment for Treatment at Student Health Center
    Emergency Evacuation and Repatriation of Remains Covered at 100% Actual Cost

Rates (Per Month)

$163

 

Benefits

Coverage

Annual/Lifetime Maximum

Unlimited

Maximum per Covered Accident or Sickness

$500,000

Sports Benefit

$10,000

Treatment Period

First Charges must occur within 30 days after the date of the Covered Accident or Sickness

Deductible Per Insured Member

$350 per Coverage Year

In Network Coinsurance Per Insured Member

80% of PPO Allowance up to $25,000; 100% Covered Expenses thereafter

Out of Network Coinsurance

Per Insured Member

60% of Usual and Customary

Maximum Out of Pocket   

Per Insured Member

$5,000

Max out of Pocket Excludes Copays/Deductibles and Non-Covered Charges

Copays:

In-Network

Copay per Visit 

Out of Network

Deductible per Visit 

Dr's Office Visit

$25

(Waived at Student Health Center)

$50

(Waived at Student Health Center)

Urgent Care

$25

$50

Hospital and Physician Outpatient Services

$50

$250

Inpatient Hospital Services

$150

$250

Emergency Room

$150

$250

Prescription Drugs

$25 Generic

$50 All Other 

(per prescription)                   

$25 Generic

$50 All Other 

(per prescription)                    

Benefit Period

Policy Termination

Extension of Benefits

3 Months if Hospitalized for a Covered Accident or Sickness at time of Coverage Expiration Date.

Pregnancy

Covered as any other condition.

Maximum for Dental Treatment (made necessary by Injury to Sound, Natural teeth only)

$2,500 Injury Only

Maximum for Chiropractic Care

$5,000

Max. for Physiotherapy (Outpatient)

30 Visits

Max. for Psychotherapy (Inpatient)

30 Days

Max. for Psychotherapy (Outpatient)

30 Visits

Emergency Evacuation/Repatriation of Remains

100% of Actual Cost

Accidental Death and Dismemberment Principal Sum

$10,000

Emergency Reunion

$2,500

Family Reunion

$2,500

 This is a brief summary of the ISP plan contained within and is not a contract of insurance. The terms and conditions of coverage are set forth in the Plan issued to the Participating Organization. If any conflict should arise between this summary and the respective Plan, the terms of the Plan will govern in all cases.

Pioneer Elite Summary Brochure