Patriot AmericaSM provides coverage for non-US citizens
traveling outside their country of citizenship for a minimum of 15 days up
to a maximum of one year. Although the Patriot America plan is not
renewable, it can be rewritten for succeeding or subsequent coverage periods.
New Deductible, Coinsurance, Eligibility, Conditions of Coverage and
Pre-Existing Condition Exclusions apply to any succeeding or subsequent
Period of Coverage. A new application also must be completed. If any group
member applying for coverage is age 65 or older, please see the Eligibility
section on panel 8 of the Patriot Group Travel Medical Insurance brochure
for additional information.
All premium rates are in US dollars and are effective through 12/31/2003.
Rates include a 2.5% surplus lines tax. A dependent child is a child shown
on the Enrollment Form over 14 days and under 18 years of age, traveling
with the group as a dependent of a group member, and for whom premium has
been paid.
ONE MONTH RATES
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