1. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Academic Exchange Grantees in the United States

2. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Health Benefit Plan  ASPE is not an insurance policy  Limited health benefits plan  Self-funded through U.S. Dept of State  Administered by Seven Corners, Inc.

3. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Eligibility  Dates on ID card  24/7 coverage in your “host” country  ASPE will not cover you outside of your host country on personal leave/vacation  Example: Grantees host country is the United States, the grantee will not be covered by ASPE for personal leave, vacation/holiday outside the United States to include Canada and Mexico.

4. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Eligibility  Leave of Absence  Not covered by ASPE  Travel outside “host country”  Covered if approved by ECA and IIE/LASPAU/AMIDEAST as part of your academic program

5. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Primary or Secondary  If ASPE is your only coverage—ASPE is primary  Contact Seven Corners for any questions related to your ASPE coverage  If you are covered by a University Insurance Policy— ASPE is secondary  Use your insurance policy for all medical treatment.  Medical bills not paid by your insurance policy can be submitted to Seven Corners for processing as long as the medical treatment is not for a pre-ex condition.  Call Seven Corners customer service if you need help.

6. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Coverage  $100,000.00 maximum per covered sickness or per injury  Medevac coverage  Repatriation coverage

7. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Co-pay  ASPE requires all exchange grantees to pay a $25.00 co-pay for office visits and a $75.00 co- pay for emergency room visits. The co-pay is printed on your ID card and will be due at the time-of-service for:  Office visits  Emergency rooms  Urgent care  Hospitalizations $25.00 co-pay for office visits

8. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Pre-existing clause  The condition originated prior to your grant start date.  You consulted a physician about the condition before your start date.  You received treatment or medication for the condition before your start date.  The medical condition would have caused a prudent person to seek advice or treatment before the start date.

9. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Exceptions to Pre-ex  Pregnancy  Prescription Medications  Prescription medications are not subject to the pre-existing clause; only medical conditions  Diabetes  office visit, blood tests would not be covered  medication such as Insulin, and syringes are covered  the Insulin pump is an exclusion and would be covered

10. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Benefit Limitations  ASPE does not cover the following:  Dental care—all dental care including routine*  Vision care—routine eye exams or glasses/contacts not covered*  Routine examinations—any type of routine medical care is not covered  Immunizations/vaccinations*

11. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Exceptions  Dental exception  Only treatment for the emergency alleviation of pain will be paid and the maximum allowed is $1000.00 per benefit year.  Call Seven Corners customer service for help in finding a dentist.

12. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Exceptions  Vision (eyes) exception  If you are in an accident and your eyeglasses/contacts are damaged, ASPE will replace or repair your eyeglasses or contacts; the maximum limit is $300.00.

13. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Exceptions  Covered immunizations/vaccinations:  Measles, Mumps, Rubella (MMR), Polio, Varicella, Tetanus, Diphtheria, Pertussis, Quadrivalent Human Papillomavirus Vaccine (HPV), Hepatitis A Vaccine, Hepatitis B Vaccine, Meningococcal Tetravalent (Meningitis), Influenza, Pneumococcal Polysaccharide Vaccine and Tetanus booster—only if booster is required by the University. In addition, Hepatitis C and Tuberculosis skin tests (PPD) are also covered.

14. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Perilous Activity—not covered Bungee jumping Sky diving Rock climbing Scuba diving

15. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Seven Corners  Administers ASPE plan  Download a copy of the Benefit Guide  Process claims  Customer service  Eligibility—enrollment  Prescriptions  www.usdos.sevencorners.com www.usdos.sevencorners.com  MyPlan (secure website)

16. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES www.usdos.sevencorners.com

17. https://myplan.sevencorners.com

18. https://myplan.sevencorners.com Click on Setup New Account

19. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES https://myplan.sevencorners.com Enter your ID number you received from IIE Enter your Date of Birth, you must use the format shown mm=month dd=day yyyy=year

20. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Virtual ID Card—pdf file Virtual ID Card—pdf file

21. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Customer Service  Staffed 24/7  Call toll free 1-800-461-0430  E-mail: usdosinfo@sevencorners.comusdosinfo@sevencorners.com  Find a doctor or hospital  Questions about ASPE or medical bills  Need forms  For hospitalization/surgery  For treatment of dental pain

22. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Provider Networks  ASPE uses a preferred provider network for medical care  First Health Network— http://firsthealth.coventryhealthcare.com/locate- a-provider/index.htm

23. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Provider Search

24. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Claim Form  If you use a provider network you do not have to file a claim form; the provider will bill Seven Corners directly.  The address for Seven Corners is on the back of your ID card

25. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Claim Form  If you do not use a provider network payment might be required upfront or the provider will bill you. You will need to file a claim form and you will be responsible for the difference in costs for using an out-of-network provider.  Claim form may be found in back of Benefit guide or online at: www.usdos.sevencorners.comwww.usdos.sevencorners.com

26. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Pharmacy Network  Catamaran  www.catamaranrx.com  Paid prescriptions—show your ID card with a written prescription at the pharmacy  Start date on ID card is the start of your ASPE coverage and your prescription coverage  If you are not in the prescription system please contact Seven Corners customer service  To find a pharmacy:  Go to www.usdos.sevencorners.com or go directly to www.catamaranrx.com to register and access a list of in network pharmacies  Call Pharmacy Member Services at 1.800.531.6351  Exclusions to the prescription program are on page 22 of ASPE Benefit Guide

27. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES  Start date on ID card is the start of your ASPE coverage and your prescription coverage  Give your ID card to the pharmacy; the information to fill your prescription is on the back. To Fill a Prescription Exchange Grantee Name Unique ID number 06/01/2012 to 05/31/2013 Citizen Country

28. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Prescription or OTC Pharmacist Over the Counter (OTC)

29. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES OTC=Over the Counter  ASPE does not cover OTC medications  OTC are items such as: aspirin, ibuprofen, cough suppressants, band-aids, topical ointments; anything you can pick up off the shelf.

30. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Reimbursement  If you are not in the system you can pay for your prescription out-of-pocket and get reimbursed  Download a copy from www.usdsos.sevencorners.com www.usdsos.sevencorners.com  Catamaran Prescription Drug Claim Form

31. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Medical Care  Campus health center  Primary Care Provider  CVS Minute clinics, Walmart Clinics, Target Clinics  Urgent Care Center  Emergency Room

32. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Primary Care Provider  Primary Care Providers are physicians who deliver basic care for common illnesses. They are your first stop for most undiagnosed health concerns.  Physicians Assistants (PA) can also treat and diagnose your symptoms  When to go  You should visit a primary doctor or PA for illnesses such as colds, flu, and sore throats; minor injuries, aches, and pains.  Check the network for doctors nearest you

33. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Urgent Care  Urgent Care Center  If your primary care physician is not available and you need quick medical attention for a non-life-threatening problem, visit an urgent care center.  Urgent care centers have comprehensive quality care on a walk-in basis with extended hours.  When to go  Go to an urgent care center when you need immediate medical attention or have non-emergency health concerns after hours. Examples include ear infections, sprains, simple cuts and burns, and eye injuries.

34. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Emergency Rooms  Life-threatening emergencies and late-night trauma require an immediate visit to the ER.  Triage—life threatening cases first…  When to go  Call 911 whenever conditions cause severe symptoms and/or put your health at serious risk. Examples include heart attacks, poisoning, severe bleeding, unable to breathe, and broken bones.

35. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES Dependents  ASPE only covers the grantee!  Grantees with dependents are required to purchase a health insurance policy  Suggested websites for information and quotes  www.sevencorners.com (commercial side) www.sevencorners.com  www.insubuy.com www.insubuy.com  www.squaremouth.com www.squaremouth.com

36. A CCIDENT AND S ICKNESS P ROGRAM FOR E XCHANGES