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Benefits Global Medical Insurance offers you the choice of three plan options: Silver, Gold and Platinum. You also have the opportunity to select a coverage area: worldwide or worldwide excluding the U.S. and Canada. Simply choose the plan option and coverage area that best fits your needs. Each one offers a full range of benefits suited for individuals and families, provides coverage 24 hours a day, and you have the freedom to choose any doctor or hospital for treatment. When you select Global Medical Insurance, you receive IMG’s commitment to deliver world class health benefits, medical assistance and Global Peace of Mind®. Benefit Description Subject to deductible and coinsurance unless otherwise noted | Silver | Gold | Platinum | | Coverage Area | Two options: worldwide or worldwide excluding the U.S. and Canada | Two options: worldwide or worldwide excluding the U.S. and Canada | Two options: worldwide or worldwide excluding the U.S. and Canada | | Policy Maximum | $5,000,000 lifetime per individual | $5,000,000 lifetime per individual | $8,000,000 lifetime per individual | | Deductible | Ranges from $250 to $10,000 per period of coverage, 50% reduction within PPO | Ranges from $250 to $10,000 per period of coverage, 50% reduction within PPO, Carry forward deductible - last 30 days of certificate year | Ranges from $100 to $10,000 per period of coverage, 50% reduction within PPO, Carry forward deductible - last 30 days of certificate year | | Family Deductible | 3x the single | 3x the single | 2x the single | | Coinsurance within the U.S. and Canada | 80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage | 80% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage | 90% of the next $5,000 of eligible expenses after the deductible, then 100% to the overall maximum per period of coverage | | Coinsurance within the PPO network and outside the U.S. and Canada | 100% | 100% | 100% | | Hospitalization / Room & Board | $600 per day (maximum of 240 consecutive days per covered event) | Average semi-private room rate | Private room rate | | Intensive Care Unit | $1,500 per day (maximum of 180 consecutive days per covered event) | Usual, Reasonable and Customary (URC) | Usual, Reasonable and Customary (URC) | | Surgery | URC | URC | URC | | Anesthetist's Charges Associated with Surgery | 20% of surgery benefit | URC | URC | | Transplants | $250,000 per transplant | $1,000,000 lifetime maximum | $2,000,000 lifetime maximum | | Outpatient | Visits/Exams - 25 visits per insured person per period of coverage to the maximum limit as outlined: physician $70; specialist $70; psychiatrist $60; chiropractor $50; surgical intervention consultation $500; X-rays - $250 per exam maximum limit; Lab Tests - $300 per exam maximum limit | URC | URC | | Rx Coverage | URC | URC | URC | | Emergency Room Illness | URC subject to an additional $250 deductible if not admitted | URC subject to an additional $250 deductible if not admitted | URC subject to an additional $250 deductible if not admitted | | Emergency Room Accident | URC | URC | URC | | Local Ambulance | $1,500 per covered event - not subject to deductible or coinsurance | URC | URC | | Emergency Evacuation | $50,000 per period of coverage - not subject to deductible or coinsurance | Limited to policy maximum - not subject to deductible or coinsurance | Limited to policy maximum - not subject to deductible or coinsurance | | Emergency Reunion | NA (Not Applicable) | $10,000 lifetime maximum | $10,000 lifetime maximum | | Return of Mortal Remains | $25,000 lifetime maximum per insured - not subject to deductible or coinsurance | $25,000 lifetime maximum per insured -not subject to deductible or coinsurance | $50,000 lifetime maximum per insured -not subject to deductible or coinsurance | | Maternity | Optional Rider - $50,000 lifetime maximum, maximum of $5,000 for normal delivery, $7,500 for C-section, $200 child wellness benefit for first 12 months - not subject to deductible or coinsurance. Available after 10 months of coverage benefits reduced by 50% for births that occur in11th or 12th month of continuous coverage | Optional Rider - $50,000 lifetime maximum, maximum of $5,000 for normal delivery, $7,500 for C-section, $200 child wellness benefit for first 12 months - not subject to deductible or coinsurance. Available after 10 months of coverage benefits reduced by 50% for births that occur in 11th or 12th month of continuous coverage | Same As Any Illness (SAAI) $1,000 additional deductible, $50,000 lifetime maximum, $200 child wellness benefit for first 12 months. Available after 10 months of coverage | | Supplemental Accident | NA | $300 per occurrence - not subject to deductible or coinsurance | $500 per occurrence - not subject to deductible or coinsurance | | Mental/Nervous | Outpatient only - (see Outpatient) Available after 12 months of continuous coverage | $10,000 per period of coverage up to a $50,000 lifetime maximum. Available after 12 months of continuous coverage | SAAI $50,000 lifetime maximum. Available after 12 months of continuous coverage | | Adult Wellness | NA | $250 per period of coverage - not subject to deductible or coinsurance Available for those 30 years of age and over after 12 months of continuous coverage | $500 per period of coverage - not subject to deductible or coinsurance Available for those 18 years of age and over after 12 months of continuous coverage | | Child Wellness | Three visits per period of coverage -maximum $70 per visit. Available for children under 18 years of age after 12 months of continuous coverage | $200 maximum per period of coverage -not subject to deductible or coinsurance Available for children under 18 years of age after 12 months of continuous coverage | $400 maximum per period of coverage - not subject to deductible or coinsurance Available for children under 18 years of age after 12 months of continuous coverage | | Other Services | Extended Care - limited to first 30 days of confinement Radiation Treatment - URC Home Nursing Care - limited 30 days per covered event Hospice Care - limited 30 days per covered event Prosthetic Devices - all URC | URC | URC | | Physical Therapy | Maximum $40 per visit 30 visit maximum per period of coverage | Maximum $50 per visit | Maximum $50 per visit | | High School Sports Injury | NA | NA | Up to $5,000 maximum | | Recreational SCUBA | NA | URC | URC | | Remote Transportation | NA | NA | Limited to $5,000 per certificate period up to a $20,000 lifetime maximum | | Political Evacuation and Repatriationz | NA | NA | Limited to $10,000 lifetime maximum | | Complementary Medicine | NA | Acupuncture $150 Aroma Therapy $50 Herbal Therapy $50 Magnetic Therapy $75 Massage Therapy $150 Vitamin Therapy $100 Each per period of coverage | Acupuncture $150 Aroma Therapy $50 Herbal Therapy $50 Magnetic Therapy $75 Massage Therapy $150 Vitamin Therapy $100 Each per period of coverage | | Non-emergency Dental | NA | NA | Calendar year maximum - $750 Individual deductible - $50 Schedule of benefits - Class I: 90% Class II: 70% Class III: 50% Ortho 0% (6 month waiting period) | | Emergency Dental due to Accident | $1,000 per period of coverage | URC | URC | | Emergency Dental due to Sudden Unexpected Pain | NA | $100 per period of coverage | See non-emergency dental benefits | | Vision | NA | NA | Exams - up to $100 per 24 months Materials - up to $150 per 24 months | | Global Concierge & Assistance Services | NA | NA | Included | | Pre-existing Conditions | $5,000 per period of coverage up to a $50,000 lifetime maximum. Available after 24 months of continuous coverage | $5,000 per period of coverage up to a $50,000 lifetime maximum. Available after 24 months of continuous coverage | SAAI | | NA (Not Applicable) / URC (Usual, Reasonable and Customary) / SAAI (Same As Any Illness) | This website contains only a consolidated and summary description of some of the current Global Medical Insurance benefits,conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request. Global Concierge and Assistance ServicesSM DEDICATED SERVICE LINE An international toll-free number accessible worldwide 24/7. DEDICATED CLAIMS TEAM Provides members with expedited claims processing. BAG TRACKING Assistance in locating lost checked baggage and arranging the delivery of it to you anywhere in the world. DRUG TRANSLATION SERVICES 24/7 online access that provides country specific brand names of common prescription and over-the-counter medications. EMBASSY & CONSULATE REFERRALS Provides the location and contact information of the nearest U.S. Embassy or Consulate. EMERGENCY CASH TRANSFERS Assists in arranging and obtaining cash transfers anywhere in the world. EMERGENCY MESSAGE RELAY Relay messages to your family, friends and co-workers, helping you maintain contact during an emergency. EMERGENCY TRAVEL ARRANGEMENTS Assists in making the appropriate travel arrangements in the event you must interrupt your travel and return home. LEGAL REFERRALS Provides the contact information for an attorney located in your country of travel. LOST PASSPORT/TRAVEL DOCUMENTS ASSISTANCE Assists in reporting, retrieval or replacement of lost or stolen travel documents. PRESCRIPTION DRUG REPLACEMENT ASSISTANCE Assists in the replacement and shipment of lost or damaged medication. PRE-TRIP HEALTH AND SAFETY ADVISORIES 24/7 online access to information concerning current passport and visa requirements; information regarding inoculations and vaccinations; and up-to-date travel safety advisories. SECURITY UPDATES AND COUNTRY PROFILES 24/7 online access to the latest advisories and travel warnings. Global Concierge and Assistance Services are additional services offered under the Platinum plan option. They are not insurance benefits. Exclusions Pre-existing conditions and exclusions
Silver and Gold: After coverage has been in effect for 24 continuous months, the Silver and Gold plan options provide a US$50,000 lifetime benefit for eligible pre-existing conditions that existed at or prior to the effective date, subject to a maximum of US$5,000 per period of coverage. This benefit is payable whether or not you have received consultation or treatment for the condition(s) during the 24-month period. The Silver and Gold plan options do not rider or charge additional premium for pre-existing conditions. If you properly disclose a pre-existing condition at the time of application and are accepted into the plan, you will be covered for eligible medical expenses after 24 months of continuous coverage, subject to the foregoing limits and the other terms of the plan.* The following illnesses which exist, manifest themselves or are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitations of coverage described above: asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast, and any condition of the prostate. Platinum: On the Platinum plan option, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are not fully disclosed on the application will not be covered. OTHER EXCLUSIONS & LIMITATIONS* Treatment not ordered or received by a physician Treatment or supplies not medically necessary Investigational, experimental or research procedures Custodial care Weight modification Elective cosmetic or plastic surgery Treatment of impotency Contraceptive medication or treatment Drug and alcohol abuse treatment Organ transplants not specifically listed Routine foot care Treatment by a relative or family member Treatment as a result of war or riot Treatment resulting from illegal activities Speech therapy Persons HIV+ at effective date Organized amateur or professional sports Maternity and newborn care (unless the maternity rider or Platinum plan option is purchased - see Summary Schedule of Benefits) Services and treatment eligible for payment by any government or other insurance Adult routine physical examinations are excluded under the Silver plan option and for the first 12 months for the Gold and Platinum plan options Devices to correct sight or hearing are excluded under the Silver and Gold plan options Inpatient mental and nervous is excluded under the Silver plan option and for the first 12 months for the Gold and Platinum plan options Outpatient mental and nervous for the first 12 months on all plan options *This website contains only a consolidated and summary description of some of the current Global Medical Insurance benefits, conditions, limitations and exclusions. A certificate containing the complete Certificate Wording with all terms, conditions and exclusions will be included in the fulfillment kit. IMG reserves the right to issue the most current Certificate Wording for this insurance plan in the event this application and/or brochure has expired, is modified, or is replaced with a newer version. Current Certificate Wordings are available upon request. Global Medical Insurance is a surplus lines product underwritten by Sirius International Insurance Corporation (publ) (the "Company"). Distributed, managed and administered, as agent for and on behalf of the Company, by International Medical Group®, Inc. ("IMG®").
Global Medical Insurance® New Business Rates
New Business Rates through 31-Oct-2008 (Includes 2.5% surplus lines tax where applicable)
| | $250.00 deductible | $500.00 deductible | $1,000.00 deductible | $2,500.00 deductible | $5,000.00 deductible | $10,000.00 deductible | | | | Age | M | F | M | F | M | F | M | F | M | F | M | F | | | | 14 Days-9** | First 2 Free*, Then 310 | First 2 Free*, Then 270 | First 2 Free*, Then 210 | First 2 Free*, Then 184 | First 2 Free*, Then 169 | First 2 Free*, Then 150 | | | | 10-18** | 317 | 282 | 233 | 217 | 204 | 180 | | * The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the Global Medical Insurance plan. **Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Male 19-24 rates. | | | | 19-24 | 718 | 895 | 622 | 881 | 484 | 675 | 422 | 588 | 331 | 473 | 294 | 407 | | | | 25-29 | 758 | 1,020 | 662 | 991 | 515 | 764 | 449 | 663 | 352 | 551 | 313 | 433 | | | | 30-34 | 848 | 1,128 | 730 | 1,063 | 566 | 823 | 496 | 718 | 389 | 576 | 345 | 490 | | | | 35-39 | 950 | 1,333 | 770 | 1,182 | 596 | 918 | 522 | 793 | 408 | 661 | 364 | 516 | | | | 40-44 | 1,202 | 1,463 | 976 | 1,273 | 647 | 997 | 567 | 873 | 542 | 676 | 482 | 602 | | | | 45-49 | 1,339 | 1,614 | 1,098 | 1,373 | 850 | 1,062 | 741 | 925 | 605 | 730 | 538 | 650 | | | | 50-54 | 1,635 | 1,796 | 1,386 | 1,548 | 1,071 | 1,201 | 935 | 1,068 | 794 | 886 | 706 | 789 | | | | 55-59 | 1,976 | 1,976 | 1,718 | 1,718 | 1,330 | 1,328 | 1,159 | 1,159 | 976 | 984 | 868 | 876 | | | | 60-64 | 2,909 | 2,738 | 2,651 | 2,480 | 2,235 | 1,973 | 2,024 | 1,816 | 1,691 | 1,502 | 1,505 | 1,337 | | | | 65-69 | 6,075 | 5,271 | 5,814 | 5,041 | 5,439 | 4,591 | 4,181 | 3,412 | 3,656 | 3,274 | 3,254 | 2,914 | | | | 70 - 74 | Please contact IMG or your agent for premium information concerning this age bracket | | Rates expire on 31-Oct-2008 |
New Business Rates through 31-Oct-2008 (Includes 2.5% surplus lines tax where applicable)
| | $250.00 deductible | $500.00 deductible | $1,000.00 deductible | $2,500.00 deductible | $5,000.00 deductible | $10,000.00 deductible | | | | Age | M | F | M | F | M | F | M | F | M | F | M | F | | | | 14 Days-9** | First 2 Free*, Then 232 | First 2 Free*, Then 203 | First 2 Free*, Then 158 | First 2 Free*, Then 138 | First 2 Free*, Then 127 | First 2 Free*, Then 112 | | | | 10-18** | 238 | 212 | 175 | 163 | 153 | 134 | | * The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the Global Medical Insurance plan. **Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Male 19-24 rates. | | | | 19-24 | 539 | 671 | 466 | 660 | 363 | 506 | 317 | 441 | 248 | 355 | 221 | 306 | | | | 25-29 | 569 | 766 | 497 | 744 | 385 | 572 | 336 | 498 | 264 | 413 | 234 | 326 | | | | 30-34 | 636 | 846 | 548 | 798 | 424 | 618 | 372 | 538 | 291 | 432 | 259 | 369 | | | | 35-39 | 714 | 1,000 | 578 | 888 | 447 | 689 | 392 | 595 | 307 | 496 | 273 | 387 | | | | 40-44 | 901 | 1,098 | 731 | 955 | 486 | 748 | 425 | 655 | 407 | 510 | 362 | 451 | | | | 45-49 | 1,004 | 1,211 | 823 | 1,030 | 638 | 797 | 556 | 694 | 453 | 548 | 404 | 487 | | | | 50-54 | 1,226 | 1,347 | 1,040 | 1,161 | 803 | 901 | 702 | 801 | 595 | 665 | 530 | 592 | | | | 55-59 | 1,482 | 1,482 | 1,288 | 1,288 | 997 | 996 | 869 | 869 | 731 | 738 | 651 | 657 | | | | 60-64 | 2,182 | 2,054 | 1,988 | 1,860 | 1,676 | 1,480 | 1,518 | 1,363 | 1,268 | 1,127 | 1,129 | 1,003 | | | | 65-69 | 4,556 | 3,953 | 4,361 | 3,781 | 4,080 | 3,443 | 3,136 | 2,559 | 2,742 | 2,456 | 2,441 | 2,185 | | | | 70 - 74 | Please contact IMG or your agent for premium information concerning this age bracket | | Rates expire on 31-Oct-2008 | New Business Rates through 31-Oct-2008 (Includes 2.5% surplus lines tax where applicable)
| | $250.00 deductible | $500.00 deductible | $1,000.00 deductible | $2,500.00 deductible | $5,000.00 deductible | $10,000.00 deductible | | | | Age | M | F | M | F | M | F | M | F | M | F | M | F | | | | 14 Days-9** | First 2 Free*, Then 501 | First 2 Free*, Then 423 | First 2 Free*, Then 322 | First 2 Free*, Then 290 | First 2 Free*, Then 260 | First 2 Free*, Then 235 | | | | 10-18** | 545 | 445 | 345 | 312 | 280 | 252 | | * The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the Global Medical Insurance plan. **Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Male 19-24 rates. | | | | 19-24 | 1,171 | 1,543 | 1,008 | 1,468 | 784 | 1,048 | 691 | 928 | 567 | 786 | 447 | 593 | | | | 25-29 | 1,212 | 1,722 | 1,058 | 1,626 | 820 | 1,167 | 721 | 1,026 | 593 | 894 | 464 | 614 | | | | 30-34 | 1,339 | 1,927 | 1,176 | 1,807 | 915 | 1,343 | 811 | 1,188 | 664 | 1,002 | 523 | 749 | | | | 35-39 | 1,388 | 2,135 | 1,234 | 1,941 | 954 | 1,492 | 845 | 1,308 | 691 | 1,117 | 543 | 770 | | | | 40-44 | 1,791 | 2,340 | 1,583 | 2,091 | 1,226 | 1,622 | 1,089 | 1,441 | 887 | 1,145 | 702 | 899 | | | | 45-49 | 2,015 | 2,434 | 1,800 | 2,196 | 1,395 | 1,708 | 1,237 | 1,511 | 1,010 | 1,166 | 796 | 916 | | | | 50-54 | 2,449 | 2,642 | 2,204 | 2,403 | 1,715 | 1,875 | 1,562 | 1,701 | 1,280 | 1,392 | 1,004 | 1,094 | | | | 55-59 | 3,101 | 3,014 | 2,843 | 2,762 | 2,219 | 2,157 | 1,957 | 1,902 | 1,648 | 1,601 | 1,286 | 1,249 | | | | 60-64 | 4,359 | 4,109 | 4,031 | 3,781 | 3,375 | 3,125 | 3,080 | 2,850 | 2,556 | 2,262 | 2,098 | 1,868 | | | | 65-69 | 9,001 | 7,849 | 8,672 | 7,521 | 8,018 | 6,863 | 6,235 | 5,633 | 5,409 | 4,869 | 4,457 | 4,014 | | | | 70 - 74 | Please contact IMG or your agent for premium information concerning this age bracket | | Rates expire on 31-Oct-2008 | New Business Rates through 31-Oct-2008 (Includes 2.5% surplus lines tax where applicable)
| | $250.00 deductible | $500.00 deductible | $1,000.00 deductible | $2,500.00 deductible | $5,000.00 deductible | $10,000.00 deductible | | | | Age | M | F | M | F | M | F | M | F | M | F | M | F | | | | 14 Days-9** | First 2 Free*, Then 376 | First 2 Free*, Then 317 | First 2 Free*, Then 242 | First 2 Free*, Then 217 | First 2 Free*, Then 195 | First 2 Free*, Then 176 | | | | 10-18** | 408 | 334 | 259 | 234 | 210 | 189 | | * The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the Global Medical Insurance plan. **Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Male 19-24 rates. | | | | 19-24 | 878 | 1,157 | 756 | 1,101 | 588 | 786 | 519 | 696 | 425 | 590 | 336 | 445 | | | | 25-29 | 909 | 1,291 | 794 | 1,220 | 615 | 875 | 541 | 770 | 445 | 671 | 349 | 461 | | | | 30-34 | 1,004 | 1,446 | 882 | 1,355 | 686 | 1,008 | 608 | 892 | 498 | 752 | 393 | 562 | | | | 35-39 | 1,042 | 1,601 | 925 | 1,456 | 716 | 1,119 | 634 | 981 | 519 | 838 | 407 | 578 | | | | 40-44 | 1,343 | 1,755 | 1,187 | 1,569 | 920 | 1,216 | 816 | 1,081 | 666 | 859 | 526 | 675 | | | | 45-49 | 1,512 | 1,826 | 1,349 | 1,647 | 1,046 | 1,281 | 928 | 1,134 | 759 | 875 | 597 | 687 | | | | 50-54 | 1,837 | 1,982 | 1,654 | 1,803 | 1,286 | 1,406 | 1,172 | 1,276 | 960 | 1,044 | 753 | 821 | | | | 55-59 | 2,326 | 2,261 | 2,132 | 2,072 | 1,664 | 1,618 | 1,467 | 1,427 | 1,236 | 1,201 | 965 | 937 | | | | 60-64 | 3,269 | 3,083 | 3,024 | 2,836 | 2,531 | 2,344 | 2,311 | 2,137 | 1,917 | 1,696 | 1,574 | 1,402 | | | | 65-69 | 6,751 | 5,887 | 6,504 | 5,641 | 6,014 | 5,147 | 4,676 | 4,225 | 4,057 | 3,652 | 3,343 | 3,011 | | | | 70 - 74 | Please contact IMG or your agent for premium information concerning this age bracket | | Rates expire on 31-Oct-2008 | New Business Rates through 31-Oct-2008 (Includes 2.5% surplus lines tax where applicable)
| | $100.00 deductible | $250.00 deductible | $500.00 deductible | $1,000.00 deductible | $2,500.00 deductible | $5,000.00 deductible | $10,000.00 deductible | | | | Age | M | F | M | F | M | F | M | F | M | F | M | F | M | F | | | | 14 Days-9** | First 2 Free*, Then 1,618 | First 2 Free*, Then 1,471 | First 2 Free*, Then 1,320 | First 2 Free*, Then 1,125 | First 2 Free*, Then 1,064 | First 2 Free*, Then 1,006 | First 2 Free*, Then 958 | | | | 10-18** | 1,712 | 1,556 | 1,363 | 1,170 | 1,106 | 1,044 | 990 | | * The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the Global Medical Insurance plan. **Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Male 19-24 rates. | | | | 19-24 | 3,040 | 5,173 | 2,764 | 4,670 | 2,449 | 4,468 | 2,017 | 3,334 | 1,838 | 3,010 | 1,598 | 2,626 | 1,367 | 2,105 | | | | 25-29 | 3,127 | 5,668 | 2,843 | 5,153 | 2,546 | 4,894 | 2,087 | 3,655 | 1,896 | 3,274 | 1,648 | 2,918 | 1,400 | 2,162 | | | | 30-34 | 3,397 | 6,278 | 3,088 | 5,707 | 2,774 | 5,383 | 2,270 | 4,130 | 2,069 | 3,712 | 1,786 | 3,209 | 1,513 | 2,526 | | | | 35-39 | 3,501 | 6,896 | 3,183 | 6,269 | 2,886 | 5,745 | 2,345 | 4,532 | 2,135 | 4,036 | 1,838 | 3,520 | 1,552 | 2,583 | | | | 40-44 | 4,357 | 7,504 | 3,961 | 6,822 | 3,559 | 6,150 | 2,870 | 4,883 | 2,606 | 4,395 | 2,216 | 3,596 | 1,859 | 2,931 | | | | 45-49 | 4,832 | 5,722 | 4,393 | 5,202 | 3,978 | 4,393 | 3,196 | 3,800 | 2,891 | 3,420 | 2,453 | 2,754 | 2,040 | 2,272 | | | | 50-54 | 5,330 | 6,163 | 4,845 | 5,603 | 4,758 | 5,142 | 3,814 | 4,123 | 3,519 | 3,787 | 2,974 | 3,191 | 2,442 | 2,615 | | | | 55-59 | 7,138 | 6,953 | 6,489 | 6,321 | 5,991 | 5,835 | 4,787 | 4,667 | 4,281 | 4,175 | 3,685 | 3,594 | 2,986 | 2,915 | | | | 60-64 | 9,809 | 9,277 | 8,917 | 8,434 | 8,284 | 7,801 | 7,018 | 6,535 | 6,448 | 6,005 | 5,437 | 4,870 | 4,553 | 4,109 | | | | 65-69 | 19,664 | 17,218 | 17,876 | 15,653 | 17,241 | 15,020 | 15,979 | 13,750 | 12,538 | 11,376 | 10,943 | 9,901 | 9,106 | 8,251 | | | | 70 - 74 | Please contact IMG or your agent for premium information concerning this age bracket | | Rates expire on 31-Oct-2008 | | | New Business Rates through 31-Oct-2008 (Includes 2.5% surplus lines tax where applicable)
| | $100.00 deductible | $250.00 deductible | $500.00 deductible | $1,000.00 deductible | $2,500.00 deductible | $5,000.00 deductible | $10,000.00 deductible | | | | Age | M | F | M | F | M | F | M | F | M | F | M | F | M | F | | | | 14 Days-9** | First 2 Free*, Then 1,353 | First 2 Free*, Then 1,230 | First 2 Free*, Then 1,116 | First 2 Free*, Then 971 | First 2 Free*, Then 923 | First 2 Free*, Then 880 | First 2 Free*, Then 844 | | | | 10-18** | 1,420 | 1,291 | 1,149 | 1,004 | 956 | 909 | 869 | | * The first two Dependent Children between the ages of 14 days to 9 years are free only when both parents or guardians are insured under the Global Medical Insurance plan. **Dependent child rates are only available when at least one parent or guardian is insured under the Global Medical Insurance plan. Children applying with no parent or guardian insured by Global Medical Insurance must use the Male 19-24 rates. | | | | 19-24 | 2,419 | 3,991 | 2,199 | 3,628 | 1,963 | 3,477 | 1,639 | 2,626 | 1,506 | 2,383 | 1,324 | 2,097 | 1,152 | 1,706 | | | | 25-29 | 2,484 | 4,388 | 2,258 | 3,989 | 2,036 | 3,798 | 1,691 | 2,867 | 1,548 | 2,583 | 1,363 | 2,316 | 1,178 | 1,749 | | | | 30-34 | 2,686 | 4,849 | 2,442 | 4,408 | 2,206 | 4,163 | 1,828 | 3,226 | 1,677 | 2,912 | 1,465 | 2,534 | 1,262 | 2,021 | | | | 35-39 | 2,767 | 5,310 | 2,515 | 4,827 | 2,289 | 4,435 | 1,886 | 3,525 | 1,728 | 3,153 | 1,506 | 2,767 | 1,290 | 2,065 | | | | 40-44 | 3,406 | 5,767 | 3,096 | 5,243 | 2,795 | 4,740 | 2,280 | 3,787 | 2,079 | 3,423 | 1,789 | 2,823 | 1,519 | 2,327 | | | | 45-49 | 3,764 | 4,431 | 3,422 | 4,028 | 3,108 | 3,683 | 2,523 | 2,976 | 2,295 | 2,693 | 1,969 | 2,193 | 1,656 | 1,830 | | | | 50-54 | 4,454 | 4,763 | 4,049 | 4,330 | 3,696 | 3,984 | 2,986 | 3,218 | 2,766 | 2,967 | 2,357 | 2,519 | 1,957 | 2,089 | | | | 55-59 | 5,492 | 5,355 | 4,993 | 4,868 | 4,619 | 4,503 | 3,716 | 3,627 | 3,335 | 3,258 | 2,889 | 2,828 | 2,366 | 2,312 | | | | 60-64 | 7,494 | 7,099 | 6,813 | 6,545 | 6,340 | 5,977 | 5,389 | 5,028 | 4,964 | 4,628 | 4,204 | 3,777 | 3,542 | 3,210 | | | | 65-69 | 14,886 | 13,053 | 13,533 | 11,866 | 13,057 | 11,391 | 12,111 | 10,438 | 9,529 | 8,658 | 8,334 | 7,552 | 6,956 | 6,315 | | | | 70 - 74 | Please contact IMG or your agent for premium information concerning this age bracket | | Rates expire on 31-Oct-20 |
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