Carte erika 2016

www.aetna.com/docfind/erika

PERIOD OF COVERAGE

D AT E O F B I R T H

FIRST NAME

E F B O O K I N G N O.

300.250.R W S

2016

LAST NAME

EF Academic Programs

G RO U P N O 884000 PAY O R I D 6 0 0 5 4

PPO NAP

Enter your zip code to find a doctor or hospital in your area. Participating doctors and hospitals are independent providers and are neither agents nor employees of Aetna.

SPORT

Tel: (+49) 89 500 70 137 (24 hrs) 1 800 847 3948 (24 hrs in USA/CA)

Fax: (+49) 89 500 70 394 Mail: erika@axa-assistance.de

To find a participating Aetna provider you can access Aetna’s Docfind on the internet;

Tel: (+1) 781 219 9100 (business hrs) 1 800 783 7447 (in USA/CA)

Fax: (+1) 859 280 1269 Mail: erika@aetna.com

c/o Inter Partner Assistance Service GmbH Grosse Scharrnstr. 36, D-15230 Frankfurt/ Oder, Germany

AXA Assistance Deutschland GmbH

Aetna Student Health P.O. Box 14101, Lexington, KY 40512 USA

For Claims outside the USA or Canada:

For all Emergencies

while in the USA or Canada:

For Claims

M A X I M U M C O M P E N S AT I O N

DEDUCTIBLES

I L L N E S S & A C C I D E N T (USD) Medical Expenses unlimited Emergency Home Evacuation unlimited Family Member Reimbursement unlimited Home Repatriation unlimited Accidental Death 10,000 Accidental Disability 50,000 BAGGAGE & PROPERTY Baggage and Property 5,000 Cash 500 Valuable Documents 2,000 D E L AY Baggage Delay (USD 100 after 24 hours) 200 Personal Delay (USD 50 after 8 hours) 900 – flight extra cost 500 PROGRAM INTERRUPTION Program Interruption unused part of program fee*) – flight extra cost unlimited – return to program 2,000 LIABILITY & LEGAL Third Party Liability 500,000 Legal Expenses 15,000

Medical deductibles

*) 50% of the unused part of program fee for University Transition Programs.

This travel insurance group policy is underwritten by Erika Insurance Ltd, Reg. No. 516401-8581, registered with the Swedish Companies Registration Office, domiciled at P.O. Box 55569, SE-102 04 Stockholm, Sweden.

For students in the USA » In-network (Aetna) benefits: No deductible applies.

Expenses are paid at 100% of negotiated rates. » Out-of-network benefits: A USD 65 per condition deductible applies.

Expenses are paid at 100% of the reasonable and customary charges.

For students outside the USA » The deductible is USD 35 per condition.

Other deductibles » Baggage & Property USD 35, Third Party Liability USD 150, Legal Expenses USD 50+10%.

HOW TO FILE A CLAIM »

»

Fill out a claim form and attach medical records, receipts, police reports etc. when sending it in.

Keep a copy.

Claim forms, general conditions and privacy rules are available at www.erikainsurance.com.