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Home / Apply Online / Print Application / Email Us PRIMARY SCHEDULE OF BENEFITSThe following is the Schedule of Benefits for the first 36 months of continuous coverage. After 36 months of continuous coverage, the Extended Coverage Schedule of Benefits shall apply.
BENEFIT OPTIONS
Seven Corners offers additional benefit options for your review and possible selection. These are in addition to the standard Reside Prime program benefits and cannot be purchased independently.
WHO NEEDS THIS PLAN?
US CitizensUS citizens relocating or spending an extended amount of time overseas, security and flexibility are two essential ingredients of their medical program. There are thousands of medical insurance programs offered throughout the world, but there are many differences in the quality of both the programs and the insurance companies offering them. As US citizens, we are accustomed to a certain degree of stability. Reside Prime is underwritten by an A "Excellent" rated insurance entity. Great care was taken to offer a program that gives insured's the same level of security abroad that they experience at home.
Foreign NationalsA comprehensive plan providing protection in your home country, as well as the freedom to travel abroad is hard to find. Finding a program with these qualities offered by a secure company is next to impossible. The Reside Prime Worldwide Medical Plan combines the stability and financial strength of a superior underwriter with the flexibility of a universal policy.
ELIGIBILITY
The Reside Prime program is available to persons of any country, who are at least 15 days of age and who have not yet reached age 75.
Applicants / Insured Person(s) in Geographical Treatment Area A must either be outside the United States and Canada at the time of Application, or must depart the United States and Canada within 30 days of the Certificate’s Effective Date. In addition, the Insured Person(s) must reside outside the United States and Canada at least 6 months during any given 12-month period to meet the Eligibility Requirements of an Insured Person(s). If an Insured Person(s) resides in the United States and Canada longer than 6 months during any given 12-month period, their Coverage shall immediately terminate. Applicants / Insured Person(s) in Geographical Treatment Area B must be outside the United States and Canada at the time of Application, or must depart the United States and Canada prior to the Certificate’s Effective Date. *It is the Insured Person’s responsibility to maintain all records regarding travel history, age and student status and provide any documents to the Administrator, which would verify the Eligibility Requirements. COVERAGE LOCATIONS
No matter where you live or travel, Reside Prime has the right solution to meet your needs. Reside Prime has two coverage areas from which to choose. If your plans include residing or traveling to the United States and Canada (Geographical Treatment Area A) and you would like to be covered in those two countries, that option is available. If your plans do not include residing in or traveling to the United States or Canada (Geographical Treatment Area B) and you would like to exclude coverage for any benefits available in those locations, a different premium schedule is available for purchase.
Make sure you are thorough in your selection. Once a Geographical Treatment Area is chosen and purchased, changes are not available on the same certificate. If you believe you will spend any time in the United States or Canada, it is best to select the Worldwide Coverage option. (Geographical Treatment Area A & B)
HOW LONG MAY I BE COVERED UNDER RESIDE PRIME?
The Reside Prime program is annually renewable as long as the Eligibility Requirements are met and the renewal premium is received. There are no additional medical questions upon renewal. The company cannot single out an individual for cancellation, they can only cancel coverage for an entire class* of insureds.
For those who continue coverage for an extended period of time (more than 36 months), Reside Prime provides for Extended Coverage Benefits. After an Insured Person is covered for 36 consecutive months and desires to continue coverage under Reside Prime, the Extended Coverage Schedule of Benefits shall become effective on the first day of the 37th month of continuous coverage. The Extended Coverage Schedule of Benefits allows the Insured Person to continue coverage, as well as control premium increases for long-term coverage.
* A “Class” is a group of people defined by a common characteristic, including but not limited to demographic group and geographic region. APPLYING FOR COVERAGE
To apply, all you need to do is complete the application in full and pay the appropriate premium, given your age category, coverage area and desired deductible amount. Be sure to answer all sections and questions as completely, accurately, and as legibly as possible. The application you complete becomes part of your Certificate of Coverage should you be accepted. After the underwriters have had an opportunity to review the application, Seven Corners may request additional information from the applicant. If you are accepted, you will receive an ID Card confirming your effective date and conditions of acceptance, as well as a claim form and a Certificate of Coverage. The Certificate of Coverage describes the program in complete detail and how the insurance can be utilized. If you are ultimately not accepted, Seven Corners will return your premium without delay.
WORLDWIDE COVERAGE
Reside Prime is designed to cover Insured Persons 24 hours a day, seven days a week, regardless of where in the world they may be located (depending upon Geographical Treatment Area purchased). As an international citizen, you will no longer need to purchase multiple insurance programs in order to have seamless protection. Coverage in the United States and Canada is limited to 6 months during any 12-month Policy Period. RENEWABILITY
The initial Period of Coverage cannot exceed twelve (12) months. The Insured Person may apply for renewal of coverage at the Renewal Rates in force at the time. The renewal Period of Coverage may not total more than twelve (12) months. Renewal(s) will be contingent upon the Insured Person submitting the applicable renewal premiums for their class, as determined by the Company. Renewal(s) will also be contingent upon the Insured Person declaring that they continue to meet the Eligibility Requirements.
After 36 months of continuous coverage, the Extended Coverage Schedule of Benefits shall become effective.
MATERNITY
Reside Prime provides maternity and newborn child benefits to eligible Insured Persons. See Schedule of Benefits for limits and conditions. A pregnancy must be Pre-Notified during the first 90 days of the pregnancy. Failure to Pre-Notify a pregnancy will result in a 25% reduction in eligible benefits. The plan does not pay expenses related to a pregnancy within the first 12 months of coverage.
INTERNATIONAL TRAVELER'S BENEFIT
When the Insured Person travels outside of their home country, in addition to the standard benefit, they will be covered for Repatriation of Mortal Remains and Emergency Medical Reunion coverage (see Certificate of Coverage for details).
NEWBORN CHILD BENEFIT
When a parent remains eligible for coverage and the pregnancy is considered an eligible pregnancy, newborn children are automatically covered for the first thirty-one (31) days after birth. In no event shall the Company’s maximum liability exceed the maximum stated in the Schedule of Benefits.
In order to continue coverage beyond the first thirty-one (31) days and be accepted as any other new Insured Person subject to the Insurance Provisions, Scope of Coverage and Exclusions sections of this Certificate or other sections relating to a Newborn Child(ren) up to the maximum amount of this Certificate, the following conditions must be met: (1) An Application and any applicable premium is submitted and Approved by the Company within thirty-one (31) days of the birth of a Newborn Child(ren); (2) The Pregnancy which led to the birth of a Newborn Child(ren) was an eligible pregnancy covered under this Certificate; (3) The mother of the Newborn Child(ren) remain covered under this Certificate; (4) The mother and Newborn Child(ren) meets and will continue to meet the Eligibility Requirements of this Certificate.
LIMITATIONS
Pre-existing Conditions: If an existing medical condition is fully and accurately disclosed on the application, and the condition is not excluded or restricted by an exclusionary rider, your pre-existing condition will be covered up to a lifetime maximum of $50,000 ($5,000 limit per year) after you have been continuously insured for 24 months.
Pre-existing conditions are any Injury or Illness which meets the following criteria: 1) A condition that would have caused a person to seek medical advice, diagnosis, care or treatment prior to the Effective Date of coverage under this Certificate; 2) A condition for which manifestation, medical advice, diagnosis, care or treatment (including medication) was recommended or received prior to the Effective Date of coverage under this Certificate; 3) Expenses for Pregnancy within twelve (12) months of the Effective Date of coverage under this Certificate.
Charges for treatment of the following illnesses or surgeries, which manifest themselves or are recommended, or in which symptoms occur during the first 180 days of coverage hereunder beginning on the initial effective date: any condition of the breast, any condition of the prostate, disorders of the reproductive system, gall stones or kidney stones, any acne diagnosis or acne related condition, or any surgery that is not emergency in nature, as emergency is defined hereunder. Note: coverage for such illnesses or surgeries may be further limited under the pre-existing condition exclusion and definition contained herein, or other exclusions contained herein.
The following conditions, treatments, supplies, services, and/or expenses are not covered: (This is a Summary of the Exclusions contained in the Certificate of Coverage.)
This brochure is only a brief description of Reside Prime. A complete description of the Master Policy Provisions and Benefits are contained in the Certificate of Coverage, which will be mailed to you once your application and premium have been received and approved by Seven Corners. To view a sample copy of the Certificate of Coverage go to www.sevencorners.com.
PRE-NOTIFICATION PROGRAM/PPO
To ensure you receive the best care possible, Reside Prime requires that the Insured Person (or someone on the Insured Person's behalf) contact Seven Corners Assist for notification prior to all hospital admissions worldwide and any medical expenses incurred within the United States that exceed $1,000 US dollars. The methods of contacting Seven Corners Assist will appear on the back of your ID Card. Seven Corners Assist will also be able to assist you in locating the approved Seven Corners medical care providers in the United States. Services and Treatment in the United States must be received at an approved PPO Service Provider facility, if one exists within a 50-mile radius of where the Insured Person is located. To obtain a list of approved PPO Service Providers contact the Seven Corners Assist or visit the approved PPO Service Provider website at: www.sevencorners.com/ppo If Services and Treatment eligible for coverage under this Certificate are received directly from an approved PPO Service Provider while the Insured Person is in the United States: (a) the Company will reduce by 50% any part of the Deductible applicable to such Eligible Benefits, and (b) the Company will waive any and all Coinsurance applicable to such Eligible Benefits. Failure to follow the Pre-Notification Program and to utilize an approved PPO Service Provider will result in a 25% reduction of the Eligible Benefits stated in the Schedule of Benefits. Utilization of a PPO Service Provider is not required when you are converted to Extended Coverage Schedule of Benefits. Our Assistance Department is available to help you locate a provider in your area should you need to seek Services and/or Treatment. EXTENDED COVERAGE SCHEDULE OF BENEFITS
After 36 months of continued coverage under Reside Prime, the following Extended Coverage Schedule of Benefits shall apply to eligible expenses beginning on the 1st day of the 37th month. All other conditions of the policy shall continue to apply.
IMPORTANT INFORMATION
It is important to note that Reside Prime is a program for international citizens and Lloyd's of London is an international entity. Thus, Lloyd's of London operates as an unauthorized insurer in most U.S. states. Coverage and benefits under Reside Prime are not regulated by any U.S. state insurance department.
The information concerning Reside Prime is not intended to be an offer to sell Reside Prime or a solicitation by Seven Corners, Inc or Lloyd's of London in any jurisdiction where any such action would be unlawful or in which Seven Corners or Lloyd's of London is not qualified to do so. Reside Prime may not be available in all situations or jurisdictions. For U.S. citizens, Reside Prime is intended for persons living or traveling outside the United States. THE UNDERWRITER
Reside Prime is underwritten by Certain Underwriters at Lloyd's of London and is rated A "Excellent" by A.M. Best and an A+ (Strong) rating from Standard and Poors. In addition to being one of the largest insurance entities in the world, Lloyd's of London has over 300 years of experience in the international insurance business. SEVEN CORNERS ASSIST
When Unpronounceable Diseases Occur In Unpronounceable CountriesSeven Corners Assist is a leading provider of customized emergency assistance services to international organizations, corporations, government entities, insurance companies, and individual travelers. Regardless of the location, Seven Corners Assist provides valuable assistance in locating the best possible medical treatment.
Foreign Country – Familiar ServiceIn today’s world, companies and international citizens must operate in strange lands and challenging environments. In some situations, individuals must travel to developing regions where the quality of care is in question. In effort to alleviate these concerns, proper worldwide medical assistance is essential.
Quality of CareWith access to a network of emergency room physicians, Seven Corners Assist is able to effectively evaluate the quality of local care. The Seven Corners Assist physician will consult with the attending physician (if available) to review local standards and discuss the proposed course of treatment. If the quality of care is in question, Seven Corners Assist will arrange medical transportation to a location where adequate care can be rendered. A Description of Our Services
The following services are available 24 hours a day, 7 days a week from a multilingual staff of service professionals.
Assistance With TravelPre-Trip Information - Provide information concerning inoculation and visa requirements for countries worldwide Weather Information - Concerning local weather conditions Exchange Rate Information - Present day currency rates, etc. Embassy Referral - Providing contact information for the nearest embassies around the world Interpreter Referral - Contact information for interpreters around the world Lost Passport - Provide directions for lost passport recovery to insureds while traveling outside of their home country Emergency Message - In the event of a medical emergency, assistance in relaying urgent messages to family, friends, or business associates at the insured’s request Hotel Accommodation - In case of insured’s hospitalization outside of their home country, assistance in locating hotel accommodation for insured’s companion
Medical Assistance While Traveling24-Hour Telephone Contact - Should medical emergencies arise, there is help in locating medical care Conference Calls - Arranging telephone conferences between your attending and home physicians Second Opinions - Arranging second medical opinions in hospital cases Emergency Messages - Relaying emergency messages to family and employer during medical emergencies Payment Guarantee - Guarantee or payment of medical bills or authorizing medical benefits according to the program for eligible benefits only Ticketing Services - 24-Hour ticketing service to arrange emergency family visits Medical Evacuations - Arranging emergency medical evacuation from medically underserved areas Repatriation - Arranging medical transportation home after treatment Medical / Travel Escorts - Arranging escorts and transportation for unaccompanied children Medical Records - Arranging transfer of medical records Remains Return - Arranging repatriation of remains for deceased travelers THE PROGRAM ADMINISTRATOR
Properly serving the medical needs of international citizens requires specialization. Most companies are not prepared to meet the unique requirements of these customers. An organization must be equipped to address foreign currencies, international doctors and hospitals, as well as unusual claim forms and documents. The Reside Prime Medical Plan is administered worldwide by Seven Corners, Inc. The professionals at Seven Corners have over 250 years of experience in claim processing and administration. Seven Corners currently serves the needs of thousands of policyholders throughout the world.
SEVEN CORNERS
Since 1993, Seven Corners, Inc. has provided international insurance plans to private citizens, governments, missionaries, students, and corporations of various nations around the globe. As a premier underwriter, Seven Corners has had the opportunity to provide innovative solutions to unique and challenging situations.
Our claims professionals are experienced in the complexity of processing international medical expenses. As an insured of Seven Corners, you can feel confident that there is someone ready to assist you with a medical situation 24 hours a day, 365 days a year.
Other services including proficient administration, responsive underwriting, and access to secure and stable insurance carriers and medical care providers worldwide.
Copyright 1998 - 2007 by Seven Corners, Inc. Reside® is a registered trademark of Seven Corners, Inc. Seven Corners® is a registered trademark of Seven Corners, Inc.
Annual Medical Premiums Effective February 1, 2009
*The Dependent Child Premium is only available when one parent (legal guardian), of a natural or legally adopted unmarried child over 14 days old and under 19 years of age (or under 24 years of age if attending a university full-time and must rely on parents for support), is also covered under the same program. No medical premium is charged for the first two (2) Dependent Children between the ages of 14 days and 9 years old if both parents are also covered under the same program.If the Applicant desires to pay premiums on a Semi-Annual, Quarterly or Monthly basis, they must do so by credit card payment only. Seven Corners will automatically debit the credit card on the due date of the premium installment. The Premium Installment Factors to be applied to the Annual Premium are as follows: Annual 1.00 / Semi-Annual 0.55 / Quarterly 0.28 / Monthly 0.10 IMPORTANT NOTICE: The premiums referenced above are applicable for the initial 12-month coverage period, only after the Applicant has been accepted by Seven Corners. Seven Corners reserves the right to increase the stated premiums based upon the Applicant’s medical condition at the time of application and underwriting. Applicants with chronic and/or severe medical conditions may be declined. At each renewal period, Seven Corners will inform the Applicant of the renewal premium for each subsequent coverage period based upon the Applicant’s age and deductible category.Attention Applicants: Certain Underwriters at Lloyd’s of London, operates as an approved Surplus Lines market in the United States. The premiums listed above include a general Surplus Lines Tax. Your State of Residence may warrant an additional Surplus Lines Tax, Stamping Fees and administration fee. Upon receipt and review of your application, Seven Corners will inform you if additional Surplus Lines Taxes and fees will apply. If so, Seven Corners will request the payment of the additional Surplus Lines Taxes and fees from you prior to issuing coverage. The additional Surplus Lines Taxes and fees shall be listed on the declaration page of your policy.Copyright 1998 - 2009 by Seven Corners, Inc. Reside® is a registered trademark of Seven Corners, Inc. Seven Corners® is a registered trademark of Seven Corners, Inc. Home / Apply Online / Print Application / Email Us
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