Understanding Your Market. Exceeding Your Expectations.
It is rare to find an insurance provider that offers flexible, specialized products and associated services for the marine industry. It is rarer still to find a company with the dedication, resources and ability to professionally administer health care benefits and deliver claims cost containment on a global basis. However, we understand the unique needs of marine crew professionals. In fact, we have an entire marine division dedicated to serving those in this important business segment.
Our team has provided specialized insurance programs for captains, officers and crew members. One such program is the International Marine Medical InsuranceSM (IMMI) plan. This customizable plan offers comprehensive medical coverage to groups of two or more marine crew professionals who live and work aboard ocean-going vessels. Among its many benefits, IMMI helps alleviate some of the burden placed upon vessel owners by the Maritime Labour Convention, which has imposed additional liabilities for medical expenses, and other liabilities related to crews working aboard their vessel.
The IMMI program, coupled with our expertise in marine claims, medical management and international services, will help you and your members properly prepare for sudden injury or illness that occur while on assignment. But we provide more than just insurance; we provide the Global Peace of Mind® marine crew professionals deserve, backed by a team of professionals committed to being there when you need us.
Medical Benefits Summary
| Calendar Year | January 1st - December 31st | |||
|---|---|---|---|---|
| Maximum Limit | $5,000,000 | |||
| Medical Concierge | The Medical Concierge Service (MCS) is a proprietary service that helps our members navigate the U.S. healthcare system to identify the highest quality, most cost-effective providers for scheduled inpatient and certain outpatient treatments. | |||
| Benefit Levels | United States Medical Concierge | United States In-Network | United States Out-of-Network | International International |
| Deductible Options | $0 | Deductible reduced by 50% up to a max. of $2,500 | $100 to $10,000 | $100 to $10,000 |
| Deductible per Family | $0 | 3 Deductibles-Deductible reduced by 50% up to a max. of $2,500 | 3 Deductibles | 3 Deductibles |
| Deductible Carry Forward | Expenses incurred during the last three months of a calendar year will be applied toward satisfaction of the deductible for the next calendar year, but only if the deductible was not met during the prior calendar year. | |||
| Coinsurance | Plan pays 100%, Member pays 0% | Plan pays 100%, Member pays 0% | Plan pays 80%, Member pays 20% | Plan pays 100%, Member pays 0% |
| Inpatient or Outpatient Services Subject to deductible and coinsurance | ||||
|---|---|---|---|---|
| Benefit | Medical Concierge | In-Network | Out-of-Network | International |
| Eligible Medical Expenses | 100% | 100% | 80% | 100% |
| Physician Visits / Services | 100% | 100% | 80% | 100% |
| Hospital Emergency Room: United States $250 additional deductible if treatment of an Illness does not result in hospital admission Hospital Emergency Room: International | Not Applicable | 100% | 80% | 100% |
| Hospitalization / Room & Board semi-private room rate. Includes nursing services and ancillary services | 100% | 100% | 80% | 100% |
| Intensive Care | 100% | 100% | 80% | 100% |
| Outpatient Surgical / Hospital Facility | 100% | 100% | 80% | 100% |
| Laboratory | 100% | 100% | 80% | 100% |
| X-rays | 100% | 100% | 80% | 100% |
| CAT Scans and MRI | 100% | 100% | 80% | 100% |
| Pre-admission Testing | 100% | 100% | 80% | 100% |
| Surgery | 100% | 100% | 80% | 100% |
| Reconstructive Surgery Surgery is incidental to or follows a covered surgery | 100% | 100% | 80% | 100% |
| Assistant Surgeon | 100% | 100% | 80% | 100% |
| Second Surgical Opinion | 100% | 100% | 100% | 100% |
| Anesthetists | 100% | 100% | 80% | 100% |
| Newborn Care During the first 31 days of life. Eligible if pregnancy is covered under the plan | 100% | 100% | 80% | 100% |
| Durable Medical Equipment | 100% | 100% | 80% | 100% |
| Pregnancy and Childbirth After 10 months of continuous coverage | 100% | 100% | 80% | 100% |
| Pregnancy Complications After 10 months of continuous coverage | 100% | 100% | 80% | 100% |
| Podiatry Care Maximum limit: $750 $250 additional deductible if treatment of an Illness does not result in hospital admission Hospital Emergency Room: International | Not Applicable | 100% | 80% | 100% |
| Chiropractic Care Not subject to deductible, maximum limit per Visit: $75, maximum visits: 20 | 100% | 100% | 80% | 100% |
| Chiropractic Care As Part of Recovery Treatment Plan For a Covered Illness or Injury Physician order is required | 100% | 100% | 80% | 100% |
| Home Nursing Care | 100% | 100% | 80% | 100% |
| Extended Care Facility | 100% | 100% | 80% | 100% |
| Transplant Lifetime maximum: $1,000,000 | 100% | 100% | 80% | 100% |
| CAT Scans and MRI | 100% | 100% | 80% | 100% |
| Pre-admission Testing | 100% | 100% | 80% | 100% |
| Surgery | 100% | 100% | 80% | 100% |
| Reconstructive Surgery Surgery is incidental to or follows a covered surgery | 100% | 100% | 80% | 100% |
| Assistant Surgeon | 100% | 100% | 80% | 100% |
| Second Surgical Opinion | 100% | 100% | 100% | 100% |
| Anesthetists | 100% | 100% | 80% | 100% |
| Newborn Care During the first 31 days of life. Eligible if pregnancy is covered under the plan | 100% | 100% | 80% | 100% |
| Durable Medical Equipment | 100% | 100% | 80% | 100% |
| Preventative Care NOT Subject to deductible and coinsurance | ||||
| Adult Preventative Care Maximum limit: $250 | Not Applicable | 100% | 100% | 100% |
| Child Preventative Care Maximum limit: $250 | Not Applicable | 100% | 100% | 100% |
| Prescriptions Subject to deductible and coinsurance | ||||
| Prescriptions | Not Applicable | 80% | 80% | 100% |
| Mental or Nervous, Substance Abuse, Counseling Subject to deductible and coinsurance | ||||
| Lifetime Maximum | $20,000 | |||
| Inpatient Mental or Nervous / Substance Abuse Maximum limit: $10,000, after 12 months of continuous coverage | Not Applicable | 100% | 80% | 100% |
| Outpatient Mental or Nervous / Substance Abuse Maximum limit per visit: $100, maximum visits per calendar year: 52, after 12 months of continuous coverage | Not Applicable | 50% | 50% | 50% |
| Emergency Services NOT Subject to deductible and coinsurance | ||||
| Emergency Local Ambulance Subject to deductible and coinsurance, Illness must result in a hospital admission | Not Applicable | 100% | 80% | 100% |
| Emergency Medical Evacuation* Lifetime maximum: $1,000,000 for insured under age 65 | Not Applicable | 100% | 100% | 100% |
| Return of Mortal Remains* Maximum limit per Insured Person: $25,000 Local Burial / Cremation Maximum limit: $10,000 Maximum limit: $10,000 | Not Applicable | 100% | 100% | 100% |
| Inter-Facility Ambulance Transfer As a result of an inpatient hospital admission | 100% | 100% | 100% | 100% |
| Vision Care NOT Subject to deductible and coinsurance | ||||
| Routine Eye Examination Available after 12 months of continuous coverage | Maximum Limit every 24 months: $100 | |||
| Corrective Lenses, Contacts, Frames Available after 12 months of continuous coverage | Maximum Limit every 24 months: $150 | |||
| Other Services NOT Subject to Deductible and Coinsurance Unless Otherwise Noted | ||||
| Amateur Sailboat Racing Subject to deductible and coinsurance | Not Applicable | 100% | 80% | 100% |
| Crew Member Return Maximum calendar limit: $2,500 | Not Applicable | 100% | 100% | 100% |
| Emergency Dental Subject to deductible and coinsurance | Not Applicable | 80% | 80% | 100% |
| Hospital Indemnity For inpatient stay outside of the United States, maximum limit per overnight: $50, maximum overnight limit: 20, maximum calendar limit: $1,000 | Not Applicable | Not Applicable | Not Applicable | 100% |
| Medical Travel Management | Reimbursement of 10% of the cost savings, up to a maximum of $7,500 back to the member where such savings arise from medically necessary non-emergency treatment, including hospitalization and surgery outside the United States. Meal allowance maximum: $100 per day | |||
| Supplemental Accident Maximum limit per covered accident: $300 | Not Applicable | 100% | 100% | 100% |
All coverage and benefits in this policy are in United States (U.S.) dollars. Benefits are subject to the exclusions and limitations and are payable only at usual, reasonable and customary charges. This is a summary and does not supersede in anyway the Certificate of Insurance and governing policy documents (together the âInsurance Contractâ). The Insurance Contract is the only source of the actual benefits provided. *Must be coordinated by the the company
Supplemental Programs
As a complement to the medical benefits, IMMI offers the following supplemental insurance programs. All amounts are in U.S. dollars.
| Dental Insurance | Plan I | Plan II | Plan III |
|---|---|---|---|
| Calendar Year Maximum per Person | $1,000 | $1,000 | $1,500 |
| Deductible | $50 | $50 | $50 |
| Schedule of Benefits | |||
| Class I, Diagnostic, Preventive Not subject to deductible (Emergency Palliative Treatment) | 100% | 100% | 100% |
| Class II, Basic Service (X-Rays, oral surgery, extractions, endodontics, periodontics, anesthesia) | 80% | 80% | 80% |
| Class III, Major Services (Prosthodontics - bridges, partial dentures, Major restorative services - crowns, inlays) | 50% | 50% | 50% |
| Orthodontia (age 19 and under) | N/A | 50% | 50% |
All benefits are subject to deductible unless otherwise noted
Group Life Insurance
- Group Life benefit includes:
- Term Life Insurance Benefit
- Accidental Death Benefit
- Dismemberment Benefit
- 10 or fewer employees:
- $10,000 minimum required
- Automatically approved up to $100,000 if member is approved for the IMMI medical plan
- Additional underwriting $100,001 - $250,000
- Group Life can be issued as a flat amount (e.g. $50,000) or by salary (e.g. 2 x salary)
- Group Life Reduction Schedule
- Less than age 65: Full amount payable
- Ages 65-69: 35% reduction
- Ages 70-74: 55% reduction
- Ages 75-79: 70% reduction
- Age 80+: 80% reduction
Medical Management Without Boundaries
The ability to access quality health care is essential when a medical emergency arises abroad. From routine medical care and check-ups to complex case management and medical evacuations, we are there to offer our expertise in cost containment and our unique blend of services, including:
International Utilization Management
The key to successfully managing rising health care costs is early identification of catastrophic cases, and then taking action to manage those cases. Precertification is used as a key tool for this early identification of a member's entry into the health care system. This allows our medical staff to be proactive in working with both the member and the providers, assuring delivery of health care in the most appropriate and cost-effective manner.
The key to successfully managing rising health care costs is early identification of catastrophic cases, and then taking action to manage those cases. Precertification is used as a key tool for this early identification of a patient's entry into the health care system. This allows our medical staff to be proactive in working with both the patient and the providers assuring delivery of health care in the most appropriate and cost-effective manner.
Prior to receiving treatment, members will need to precertify the following procedures to avoid a reduction in benefits:
- In-patient treatment
- Inter-facility transfer
- Maternity
- Surgery or surgical procedure
- Treatment in an extended care facility
- Home nursing care
- Chemotherapy
- Radiation Therapy
- All transplants
Medical Travel Management
The Medical Travel Management benefit offers the member who is contemplating non-emergency medical treatment in the United States the opportunity to be financially compensated for having that care rendered by a qualified medical provider(s) outside of the U.S.
When treatment is received outside of the U.S., and there is greater than $10,000 cost savings to the Plan, the member will personally share in any cost savings that are realized. The cost savings are calculated using the average U.S. cost of the medical service compared to the actual cost of the medical procedure and associated medical travel costs performed by the non-U.S.-based provider(s).
International Comprehensive Care
Our medical staff will help coordinate care for your members who have highly complex cases requiring detailed management. These services may include assisting with:
- Concurrent review and monitoring of services for medical necessity
- Coordination of the hospitalization and any necessary post-discharge care
Additional Information
Customizable Solutions
We are confident that IMMI will provide quality medical coverage specific to your organization and group member's needs. For groups of a certain size, IMMI also offers the flexibility to customize benefits. Please contact us for more information. Our reputation for excellence has been built on providing top-tier programs to organizations like yours around the world, and we will work closely with you to design a benefits package to meet your unique needs.
Administrator
IMGP.O. Box 88509
2960 North Meridian Street
Indianapolis, IN 46208-0509 USA
FOR ADDITIONAL INFORMATION
Insubuy®, Inc.4200 Mapleshade Ln, Suite 200
Plano, TX 75093
Toll Free:
(866) INSUBUY
Phone:
(972) 985-4400
Fax:
(972) 767-4470
Website:
www.insubuy.com
This invitation to inquire allows eligible applicants an opportunity to seek information about the insurance offered and is limited to a brief description of any loss for which benefits may be payable. Benefits are offered as described in the insurance contract. Benefits are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations and exclusions in the insurance contract.
Certain contracts do contain a pre-existing condition exclusion and do not cover losses or expenses related to a pre-existing condition.
This brochure contains many of the valuable trademarks, names, titles, logos, images, designs, copyrights and other proprietary materials owned and registered and used by International Medical Group, Inc. and its representatives throughout the world. © 2007-2016 International Medical Group, Inc. All rights reserved.
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