The Importance of Student Health Insurance While Studying Abroad

1. The Importance of Student Health Insurance While Studying Abroad Teresa Koster President, Koster Insurance Agency 500 Victory Road Quincy MA 02171 617-770-9889 800-457-5599 tkoster@kosterins.com June 14, 2006

2. Introduction • The objective of this presentation is to identify concerns, realities and health insurance solutions for your students participating in your Study Abroad program. • Areas Being Addressed: • Insurance Coverages • Health/Disease Risks

3. Study Abroad Program Options • Institution-Supported Programs • The Institution should have clear policy & procedures governing their Study Abroad Program • Processes all paperwork, arranges housing, and makes tuition and housing payments on students’ behalf. • Provides official transcript with U.S. grade and credit equivalents. • Independent Programs • Approved for credit transfer through other hosting Universities • Offers more options and may cost less for students • Requires students to complete paperwork directly with host school, handle housing arrangements and currency transfers Pre-departure Orientation should be a requirement for whatever type of program is selected!

4. The Growth of Study Abroad Programs • Nationally, in 2003-2004, 191,321 U.S. students studied abroad, a record number according to the Institute of International Education. • Since the 2000-2001 academic year, the number of students studying abroad nationally has gone up almost 20 percent. • Only 6 percent of students study abroad for a full academic year, compared with 38 percent who go for a semester. Summer programs and those lasting less than eight weeks now enroll nearly 46 percent of all study-abroad students. Source: Chronicle of Higher Education (11/18/2005)

5. Trends in Study Abroad Destinations • Top 2003-2004 Destinations for U.S. Students • Britain 32,237 • Italy 21,922 • Spain 20,080 • France 13,718 • Australia 11,418 • Mexico 9,293 • Germany 5,985 • Ireland 5,198 • China 4,737 • Costa Rica 4,510 • Japan 3,707 • Austria 2,444 • New Zealand 2,369 • Cuba 2,148 • Chile 2,135 Source: Chronicle of Higher Education 11/18/05

6. Trends in Study Abroad Destinations • While the majority of students still head to Europe (with the largest contingent going to Britain), Europe’s share has dropped from 67% to 61% in the past decade. • Asia & Latin America are increasingly popular • The number of American students going to China jumped 90%, following a 36% drop between fall 2001 and fall 2002 (during which time many colleges cancelled Chinese programs due to the SARS virus). Source: Chronicle of Higher Education (11/18/2005)

7. Insurance Coverages • Proper Insurance Concerns • What Students Should Ask of Their Health Insurance Provider • Coverage available under sponsored University Student Health Insurance • Coverage available under stand-alone marketed plans

8. Proper Insurance Concerns • No student should travel abroad without sufficient medical insurance coverage for all possible medical needs, Including medical evacuation and repatriation. • Research indicates that most Study Abroad participants do not have comprehensive insurance for travel outside the U.S. • Parents’ plan often offer limited coverage outside the U.S. or are restricted in the length of coverage. • Students need to be aware of their limits of coverage (pre-existing conditions, deductibles, reimbursement, etc.). • Students seeking health care abroad should understand that medical systems outside the U.S. may operate differently from those in the U.S. and are not subject to the same rules and regulations. • Purchasing the International Student ID Card ($25 at http://www.isecard.com) provides very basic medical benefits that cover up to $2,000 in medical expenses, up to $5,000 in evacuation fees or costs, and a 24-Hour Emergency Hotline Services.

9. Health Insurance Check List for Students Studying Abroad Insurance Requirements: • Does your insurance plan meet all requirements of the program you are studying abroad through as well as the country you are traveling to? • Does your insurance provider limit or exclude coverage of any services while overseas? • Does your insurance provider limit which doctors, hospitals or other medical facilities you may go to? • Do you have access to emergency assistance services while overseas, such as somewhere to call to be referred to the nearest appropriate doctor or hospital in your area? • Does your insurance plan cover Emergency Medical Evacuation and Repatriation? (most study abroad programs require these benefits)

10. Health Insurance Check List for Students Studying Abroad Information Students Need to Have: • Are there other health insurance requirements in order to get a visa to enter the country you are studying in? • Do you have a copy of your current health insurance card and important policy information to take with you? • Will you have phone or email access to your insurance provider in case you have a question about coverage or limitations while abroad? Getting Reimbursed for Medical Expenses Incurred: • Are you required to pay up front for services and submit bills for reimbursement based on your plan? • Are you required to have specific information from any doctors or hospitals you may visit while overseas in order to be reimbursed under your policy? • Does your insurance provider require all claims to be submitted in English/US dollars? Do they offer translation services?

11. Coverage Available through University-sponsored Plans • University Accident & Sickness Insurance Plans should include the following coverage for travel abroad: • Coverage for Medical Evacuation and Repatriation • Worldwide Medical Coverage • 24-hour Travel Assistance Service • A minimum of 80% Coverage for Usual & Customary Medical Expenses • A minimum Plan Maximum of $50,000 per condition Benefit

12. Coverage Available Through Koster Insurance “Stand-Alone” Product • Comprehensive Short-term “Study Abroad” Health Insurance Plan: • $250,000 lifetime aggregate maximum per condition • Covers emergency and non-emergency medical expenses on an in or outpatient basis • Includes high limits for medical evacuation ($100,000) and repatriation benefits ($25,000) • Provides travel assistance services • Accidental death and dismemberment benefit (up to $15,000) • Offers optional coverage for Home Country Extension of Benefits • Term of coverage can be a minimum of one month to 12 months • Very responsible premiums (i.e. age 18-24, $39 per month) • Coverage available in all Countries

13. What is Medical Evacuation? • Emergency Medical Evacuation means: the Student’s medical condition warrants immediate transportation from the place where they are injured or ill to the nearest hospital where appropriate medical treatment can be obtained; or for Students after being treated at a local hospital; their medical condition warrants transportation to their Home Country to obtain further medical treatment to recover. • Expenses covered under the Medical Evacuation Benefit include: transportation, medical services, and medical supplies necessarily incurred in connection with Emergency Medical Evacuation. • All transportation arrangements made for evacuating the Student must be by the most direct and economical conveyance, and typically approved in advance. • Expenses for special transportation (air ambulance, land ambulance, private motor vehicle) must be recommended by the attending doctor, or required by the standard regulations of the conveyance transporting the Student. Evacuation insurance only includes transportation care costs, not the cost of actual medical care. • Evacuation can cost $8,000 to $50,000 or more.

14. What is Repatriation of Remains? • Should a student die while abroad, repatriation insurance would cover the cost of transporting his or her body back to the United States • The cost of repatriation can be $10,000-$15,000 or more. • If a student dies abroad, the U.S. Consulate can assist in planning, but will not cover any costs. • Additional costs may include transporting relatives of a deceased student abroad in order to accompany that student’s remains. • In the event of the death of a Covered Person, the Company will pay the actual charges for the covered expenses for the preparation and transportation of the Covered Person’s remains to his or her Home Country. This will be done in accord with all legal requirements in effect at the time the body remains are to be returned to his or her Home Country. The death must occur while the person is insured for this benefit. Covered expenses include, but are not limited to, expenses for embalming, cremation, coffin, and transportation.

15. Health/Disease Risks • Students must be properly educated on the health and disease risks of their new host country • The Center for Disease Control and Prevention (CDC) provides excellent alerts advisory notices to travelers • Be aware of travel advisories, new travel guidelines and other travel information • A travel advisory recommends that nonessential travel be deferred • A travel alert does not advise against travel, but informs travelers of a health concern and provides advice about specific precautions • Updated vaccinations are key to managing potential exposure to new diseases • The number one health risk for people age 15-24 traveling abroad is unintentional injuries

16. Specific Health Risks • Rabies is an epidemic in domestic animals • HIV/AIDS and other sexually transmitted diseases are more common • Insects and animals are a major source of disease (i.e. Malaria) • Drug Abuse • Airborne Respiratory Conditions are easily transmitted (i.e. SARS, Avian Flu)

17. Avian Flu Status Report • The risk of avian influenza to travelers is very low • Only rare cases of human infection with avian influenza have occurred, and there has been no sustained human to human transmission • Travelers to areas affected by avian influenza (Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey, Viet Nam) in birds are not considered to be at elevated risk of infection unless direct and un-protected exposure to infected birds occurs Source: http://www.cdc.gov/travel

18. CDC Avian Flu Travel Tips • Traveling to an Affected Area • Avoid contact with live poultry and wild birds • Avoid visiting live animal markets and poultry farms • Avoid contact with surfaces contaminated with animal droppings/feces • Avoid handling birds found dead • Do not eat or handle undercooked or raw poultry, egg or duck dishes • Exercise good personal hygiene with frequent hand washing • After You Return from an Infected Area • Monitor your health for 10 days. • If you become ill with a fever plus cough, sore throat, or trouble breathing during this 10 day period, consult a healthcare provider. Before you visit your health care provider inform them of: • your symptoms • where you traveled • if you have had direct contact with poultry or close contact with any severely ill person or persons

19. Internet Resources • NAFSA: Association of International Educators- Education Abroad Network • http://www.secussa.nafsa.org • Center for Disease Control- Travelers’ Health • http://www.cdc.gov/travel/ • Travel Health Online • https://www.tripprep.com/scripts/main/default.asp • U.S. Dept of State Travel Warnings • http://travel.state.gov/travel/cis_pa_tw/tw/tw_1764.html • U.S Customs Traveler Information • http://www.customs.gov/xp/cgov/travel/ • Travel Safety from FirstGov • http://www.firstgov.gov/Topics/Usgresponse/Travel_Safely.shtml

20. Contacting Koster • For more information about Student Study Abroad Insurance, please contact Teresa Koster, President of Koster Insurance Agency at 800-457-5599 x222, or tkoster@kosterins.com. • To download Study Abroad Plan brochures, please visit http://www.kosterweb.com or http://www.studentcare.com