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TO THE STUDENTSMountain State University is not only dedicated to the education of it’s students, but also to their general health and well being. International Students are required to have insurance while attending the University. International Students are required to be insured under the Policy. Waiver may only be granted if proof of comparable coverage is provided and the waiver form is completed. Please take the time to review this Brochure as it briefly describes the benefits of the International Student Health Insurance Program. The brochure is a general plan brochure, the overview of the Mountain State University plan is below. Please familiarize yourself with the coverages and the exclusions. Certain exclusions such as Pre–Existing Conditions not being covered are important for you to know. If you have any questions regarding the coverages or exclusions, please call K & K Consulting Services Inc. at (253) 238–6374 or 866-552-8834 toll-free. You can email K & K Consulting Services at info@betins.com. Additionally you may contact the IMG® customer service number at 1–800–628–4664, or email insurance@imglobal.com.
ELIGIBILITYAll International Students are required to have insurance while attending the University. International Students are required to be insured under the Policy or waive with proof of alternate, comparable coverage. Students who enroll may also insure their spouse and any dependent children under age 19, or 23 if enrolled as a full–time student. Newly born children of the Insured Student will be covered from birth through the first 31 days. Continued coverage beyond 31 days from birth is subject to additional premium. If you have any questions concerning eligibility requirements, please contact K & K Consulting Services Inc. at (253) 238–6374 or 866-552-8834 (toll-free), or email info@betins.com. You can contact International Medical Group at 1–800–628–4664 or email insurance@imglobal.com.
EFFECTIVE AND TERMINATION DATESThe Master Policy on file at the University becomes effective at 12:01 a.m., August 21, 2006. An eligible person becomes insured with the payment of the proper premium on the latest of the plan effective date, the first day of the quarter/semester, the date the student enters the eligible class, or the day he enrolls for coverage under the Plan. The Master Policy terminates at 12:01 a.m., August 21, 2007. Your insurance will end for you and your dependents on the earliest of the date you are no longer in an eligible class, you become full time active duty in any Armed Forces, you reach the end of the period for which premium was paid, the Policy is terminated, or the date you cease to be a participant under the Policy. Students who re–enroll within 30 days of the effective date of coverage will not experience an interruption in coverage. In the event a student withdraws from school during the first 31 days of the period for which coverage is purchased, there will be no coverage hereunder. Upon the Company’s receipt of written notification of such withdrawal, a full refund of premium will be made. Should an Insured withdraw from the school after the first 31 days and not enter military service, his/her insurance shall remain in effect until the termination of the Policy term for which premium was paid. No student shall be entitled to a refund of premium because of withdrawal from the school. THIS WEB PAGE IS INTENDED AS A GENERAL SUMMARY OF THE INSURANCE BENEFITS. The Master Policy on file at the College contains all of the provisions, limitations, exclusions and qualifications of your insurance benefits, some of which may not be included on this page or in the brochure. If any discrepancy exists between the Brochure and the Master Policy, the Master Policy will govern and control the payment of benefits. This plan does not provide "Home Country" coverage. Home Country is defined as the country which has issued your passport. This web page and brochure are based on Policy # EPSWN00138341 and Policy # EPSWN00143631
Exchange Program Group PlanMountain State University (see precertification requirement below)
*Usual Reasonable and Customary (URC) charges for eligible expenses in the area where your receive treatment.
PrecertificationEach proposed hospital admission, inpatient or outpatient surgery, and other procedure as noted in the Certificate Wording must be Precertified for the medical necessity, which means the insured person or their attending physician must call the number listed on the IMG identification Card prior to admittance to a hospital or performance of a surgery. In case of an Emergency Admission, the Precertification call must be made within 48 hours of the admission, or as soon as reasonably possible. If a hospital admission or a surgery is not Precertified, eligible claims and expenses will be reduced by 50%. Precertification is no an assurance of coverage, a verification of benefits or a guarantee of payment. All medical expenses must meet usual reasonable, customary and eligible payment guidelines. Please referr to the certificate Wording for full details of the percertification requirements. For precertification, emergency evacuation and repatriation, please call: Begin the Precertification process only (not to be used for Emergency Evacuation or repatriation).
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