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home ̱б ̱б G ~ L
 
Indiana University of Pennsylvania ̱бIndiana University of Pennsylvania
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Ͻø û ۼ ֽðų ̸ ֽø ˴ϴ.
ǽð Ͻø MSN ȭ ߰ ֽø ܱ ô Ǹ ϽǼ ֽϴ.

 

  

 

   Indiana University of Pennsylvania б .

 

 

Insurance  Provider

 

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DBغ

 

 

Life Maximum

 

 

 

$50,000

 

 

Unlimited

 

 

 

Major Benefit

 

 

$50,000

 

$50,000 per Sickness or Injury

Copayment

 

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In Network:

 

80% up to $2,500

 

ȸ翡100%

 

Out of Network:

 

60% of Reasonable &

 

Customary Charges up to

 

$2,500

 

ȸ翡100%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2010-2011 SUMMARY OF BASIC INSURANCE BENEFITS


FOR EACH INJURY OR SICKNESS COVERAGE IS PROVIDED UP TO $2,500 BASIC BENEFIT AS SPECIFIED BELOW.
MAJOR MEDICAL BENEFITS ARE PROVIDED UP TO $50,000 FOR COVERED INJURY & SICKNESS AS SPECIFIED BELOW.
This Policy provides benefits for the Reasonable and Customary Charges incurred by a Covered Person for loss due to a covered Injury or Sickness
up to the Maximum benefit of $50,000. Benefits will be paid up to the Maximum Benefit for each service as specified in the following schedule.
Injury Expenses are paid to Plan Maximum; 80% Preferred Provider, $500 OOP Max, 60% Non-Preferred Providers, $500 OOP Max
Collegiate Sports Injuries covered to a $2,500 Maximum, Club Sports Injuries covered to a $1,000 Maximum.



 

 

 

 

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