GLOBAL

EDUCATORS

INSURANCE

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GLOBAL EDUCATORS INSURANCE

Gateway Global Educators Medical (GEM)

Offers worldwide group coverage to full-time employees of international schools.

PLAN HIGHLIGHTS

• Comprehensive, long-term employer-sponsored medical plan
• Policy maximum $5,000,000
• Deductible options to $25,000
• Coverage for groups
• Access to MyIMG
• Dental coverage
• $500 per year wellness benefit
• Continuation of coverage benefit
• Mail Order Drug benefit
• Flexible plan design

Who the plan is designed for:
The staff of international schools and universities including:
• U.S. and non-U.S. employees
• Third country national employees
• Local national employees
• Dependents may be located in their home country

WORLDWIDE COVERAGE

Maximum Lifetime Benefit Per Person  |  $5,000,000 (Standard)
Deductible (Calendar Year)  |  $100 – $25,000
The deductible is reduced 50% when using the U.S. independent Preferred Provider Organization (provided through The First Health Network)
Family Deductible (Calendar Year)  |  Maximum of three (3) deductibles per family
Deductible Carry Forward  |  Expenses incurred during the last 3 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 PERCENTAGES
Adult Wellness Benefit  |  Plan pays up to $500 per calendar year
Child Wellness Benefit  |  Plan pays up to $500 per calendar year
Illness or Accident Benefit  |  Subject to deductible and applicable coinsurance

PHYSICIAN OFFICE SERVICES
Medical expenses incurred outside the U.S., Canada, or Puerto Rico  |  Plan pays 100% of eligible charges after deductible
Medical expenses incurred in the U.S. using the PPO  |  Plan pays 100% of eligible charges after deductible
Medical expenses incurred in the U.S., Canada, or Puerto Rico outside the PPO | Plan pays 80% up to $2,500 of eligible charges after deductible; thereafter the plan pays 100% of eligible charges

HOSPITAL SERVICES
Inpatient & Outpatient
Emergency Room (injury or illness)  |  Subject to deductible and applicable coinsurance
Eligible Medical Expenses  |  Subject to deductible and applicable coinsurance
Local Ambulance  |  Subject to deductible and coinsurance for emergency local transport deemed medically necessaryEmergency Medical Evacuation  |  Up to the lifetime maximum benefit per person
Emergency Reunion  |  $10,000 per insured person (return to home country)
Return of Mortal Remains  |  $10,000 per insured person (return to home country)
Maternity Coverage  |  Covered as any other illness
Pre-natal care; delivery of newborn; post-natal care  |  Subject to deductible & coinsurance per person
Newborn baby care  |  Routine care for first 31 days of life
Human Organ Covered Transplants  |  $5,000,000 lifetime maximum inside transplant network facilities per person
Durable Medical Equipment  |  $10,000 (lifetime maximum benefit)
Home Health Care & Extended Care Facility  |  URC up to a maximum of
90 days coverage  |  Chiropractic Care$30 per visit, maximum of $1,000 per calendar year
Physical Therapy  |  $50 maximum benefit per visit
Prescription Drugs  |  Mail order and retail pharmacies usual, reasonable, and customary charges
Supplemental Accident  |  $300 benefit per accident, deductible and coinsurance thereafter

VISION BENEFITS
Exams  |  Plan pays up to $100 per 24 months
Materials (frames, lenses, contacts)  |  Plan pays up to $150 per 24 months

MENTAL/NERVOUS, ALCOHOL & SUBSTANCE ABUSE TREATMENT
Inpatient  |  Maximum of 30 days confinement
Outpatient  |  Payable at 50% after deductible
Inpatient and outpatient  |  $25,000 lifetime maximum
Family Counseling  |  $500 lifetime maximum
Bereavement Counseling  |  $100 benefit per person within 6 months of the covered insured person’s death
Pre-Admission Certification  |  Failure to pre-certify maternity, admissions, and surgeries could reduce benefits

COMPLEMENTARY MEDICINE BENEFITS
Acupuncture  |  $150
Aroma Therapy |  $50
Herbal Therapy |  $50
Magnetic Therapy |  $75
Massage Therapy |  $150
Vitamin Therapy |  $100
Hospice Care  |  Up to the lifetime maximum limit

EXCLUSIONS

The following is a summary of services that are not covered under GEM:
War and terrorism (limited “innocent bystander” coverage is included under the plan)

Treatment, services or supplies that are not administered or ordered by a licensed physician, or services or supplies performed or provided by a relative

Treatment, services, or supplies that are not medically necessary or charges that exceed Usual, Reasonable, and Customary charges

Surgeries or treatments that are investigational, experimental, or for research purposes

Confinement primarily for custodial, educational or rehabilitative care

Exercise programs, weight modification or treatment for obesity

Treatment or surgery for cosmetic or aesthetic reasons, except for reconstructive surgery incidental to or following other covered surgery

Treatment for a person who was HIV+ prior to the person’s effective date

Artificial insemination, infertility, impotency, sterilization or reversal of sterilization

Hearing aids, TMJ dysfunction, orthoptics and visual eye training

Injury sustained from Hazardous Sports activities

Self-inflicted injury or illness, charges resulting from or during the commission of a crime or felony, or injury sustained while under the influence of alcohol or drugs

Speech, vocational, occupational, biofeedback, acupuncture, recreational, sleep or music therapy

Certain care, treatment or supplies for the feet

Care and treatment for hair loss

Injury or illness that is covered under workers’ compensation or similar laws

ADDITIONAL SERVICES

Emergency Travel Assistance
Even the smallest disruption can be an emergency when you are abroad. You may lose your prescription medication and need a replacement, or maybe you are a victim of a “pick pocket” and your passport is stolen and you need assistance replacing it. IMG offers a complete arrangement of emergency travel assistance services so you can spend more time enjoying your international experience and spend less time worrying about your medical security.

Emergency Travel Arrangements
In the event you must return home or discontinue your trip as a result of an interruption in travel due to an illness of your spouse, child, parent, in-law, or grandparent, IMG will help you make the appropriate travel arrangements. You are responsible for the cost of the travel tickets that are not eligible under your benefit plan.

Lost Passport/Travel Documents Assistance
IMG will help you report, retrieve or replace lost or stolen travel documents, such as your passport, credit cards and airline tickets.

Lost Luggage Assistance
IMG will assist you in communicating with the commercial carrier for the return of your lost luggage.

Embassy or Consulate Referrals
IMG will inform you of the location and contact telephone numbers for the nearest embassy or consulate, no matter where you are.

Emergency Message Relay
IMG will receive or transmit emergency messages between you, your family and your employer.

Emergency Prescription Replacement
IMG will assist with the replacement of lost or damaged prescription medication. You are responsible for the cost of the actual medication and shipping costs (if any).

Medical Referrals
If urgent medical advice or care is needed, IMG is prepared to refer you to the nearest appropriate care facility or provide a listing of available medical care to you. IMG will also help with obtaining an appointment with the medical care provider you have chosen.

24-Hour Medical Monitoring
If you are hospitalized, IMG will provide medical professionals to communicate with your treating doctor(s) and help you monitor your condition. IMG can also communicate with your family doctor as you direct.

Emergency Cash Transfer
IMG will help you transfer your funds in the event of a medical or travel emergency.

Legal Referrals
IMG will provide you with a referral to an international attorney specializing in the area of your specific need.

Emergency Translations
IMG will provide personal, emergency telephone translation services and referral to a local interpreter sevice should you require language assistance.

CONTACT US

If you have any questions regarding IMG or the products located on this website, please contact us. We are available to provide support to our producers and prospective clients. Our contact information is below. Additionally, you may use the online inquiry form. An IMG representative will review your questions or comments, and respond in a timely manner.

International Medical Group
2960 North Meridian Street
Indianapolis, IN USA 46208-4715

Telephone: 1.317.655.4500 or 1.877.808.7434
Fax:1.317.655.4505
Email: insurance@imglobal.com

For all claims correspondence, please use the following address:
International Medical Group
Claims Department
PO Box 88500
Indianapolis, IN 46208-0500

To submit applications, underwriting information or premium, please use the following address:
International Medical Group
PO Box 88509
Indianapolis, IN 46208-0509

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