Make every adventure a healthy one Aetna Travel Benefits schedule
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1 Make every adventure a healthy one Aetna Travel Benefits schedule USD HKD For plans with a start date on or after 1 January 2016 Visit M E
2 Whether you re getting to know your plan or choosing how to use it, this Benefits schedule will provide the details you need. 2
3 Aetna Travel add-on plan Benefits schedule 2016 Under the terms and conditions of the plan, cover is provided during the plan year for trips you make of no more than 180 days at a time. Reasonable costs will be paid up to the limits shown for each benefit below. 1 MEDICAL BENEFITS (SEE SECTION 10 FOR DEDUCTIBLES) Inpatient, daycare and outpatient treatment needed for any one or more medical conditions you suffer during a trip. Reasonable additional accommodation costs that you have to pay if you cannot return to your country of residence due to any one or more medical conditions covered under section 1.1. Economy class travel costs to return you to your country of residence if you cannot return as originally booked due to any one or more medical conditions covered under section 1.1. If the member is an insured child under the age of 18 we will pay the following costs for a parent or legal guardian: Hospital accommodation costs for them to stay with the child if the child is receiving inpatient treatment covered under section 1.1 Reasonable accommodation costs for them to stay with the child if the child cannot return to their country of residence and the child s accommodation costs are covered under section 1.2 Economy class travel costs to accompany the child, if the child is unable to return to their country of residence as originally booked and the child s travel costs are covered under section 1.3 Dental treatment needed for the immediate relief of dental pain you suffer during a trip. USD 3,400,000 HKD 26,000,000 in each plan year USD 1,700 HKD 13,000 within the limit shown in section LOSS OF DEPOSITS, CANCELLATION OR CURTAILMENT (SEE SECTION 10 FOR DEDUCTIBLES) You or your personal representative will be paid for the loss of irrecoverable deposits, pre-payments and any other costs paid, or contractually due to be paid, for travel or accommodation, if your trip has to be cancelled or curtailed as a direct result of any one or more of the following that happens after a trip is booked: 2.1 Your death A medical condition you suffer The death of, or a medical condition suffered by: - the person you are travelling with, or had arranged to travel with, or - a close family member. You, the person you are travelling with, or the person you had arranged to travel with: - having to attend jury service, - having to attend as a witness in a court of law under subpoena, or - being restricted by compulsory quarantine. A listed natural disaster or similar force majeure The amount that will be paid for cancellation claims is limited to the scale of cancellation charges as defined in the booking conditions of your trip. USD 5,100 HKD 39,600 3
4 3 TRAVEL DELAYS 3.1 Cash payment made to you for each full 12 hours that you are delayed because of strikes, industrial action, adverse weather conditions, mechanical breakdown, or failure of any aircraft, sea vessel, train or other form of public transport. USD 85 HKD 650 paid for each full 12 hours, up to USD 255 HKD 2,000 4 MISSED DEPARTURES AND TRAVEL DISRUPTION (SEE SECTION 10 FOR DEDUCTIBLES) Additional travel and accommodation costs you have to pay to connect with your group or tour, or reach your final destination, if you miss your original departure because of: 4.1 adverse weather conditions, mechanical breakdown, or failure of the public transport that you were using to reach your point of departure USD 1,700 HKD 13,000 5 HIJACK 5.1 Cash payment made to you for each full 24 hours that you are unable to reach your destination because your transport is hijacked. USD 170 HKD 1,300 paid for each full 24 hours, up to USD 2,550 HKD 20,000 6 BAGGAGE AND PERSONAL EFFECTS (SEE SECTION 10 FOR DEDUCTIBLES) Damage to, loss of or theft of your property that happens: when you send the property in advance, up to 24 hours before the departure date shown on your itinerary, or during your trip, to property that you take with you or purchase during your trip You will be paid the intrinsic value of your property, or the cost to repair or 6.1 replace it, whichever is less. A maximum of USD 510 will be paid for any one item, or pair or set of articles. The maximum amount that will be paid for all photographic, audio, video, computer and electrical equipment of any kind, mobile phones, spectacles, sunglasses, binoculars, telescopes, musical instruments, antiques, fine art, furs, leather goods, animal skins, watches, jewellery, and any items made of, or containing, gold, silver, precious metals, precious or semi-precious stones is USD 510. USD 3,400 HKD 26,000 7 DELAYED BAGGAGE 7.1 Costs of essential toiletries and clothing, if your baggage is delayed on your outward journey for 12 or more hours from the time of your arrival. USD 170 HKD 1,300 8 LOSS OF MONEY (SEE SECTION 10 FOR DEDUCTIBLES) 8.1 The value of any cash, traveller s cheques or postal or money orders that are stolen or accidentally lost during your trip. USD 850 HKD 6,500 4
5 9 LOSS OF PASSPORT AND TRAVEL DOCUMENTS (SEE SECTION 10 FOR DEDUCTIBLES) 9.1 Costs of replacing travel documents owned or held by you if they are lost or stolen during your trip. This includes the cost to replace one passport. This benefit extends to any additional accommodation and travel costs that you have to pay during your trip to replace the travel documents. USD 850 HKD 6, DEDUCTIBLES 10.1 Excess applies to sections 1, 2, 4, 6, 8 and 9. This deductible is applied to each claim. USD HKD 330 All cover provided under this Benefits schedule is subject to the terms and conditions in your plan. Some words and phrases used in this Benefits schedule have specific meanings that are relevant to your plan. We have highlighted them in bold print and defined them in the Definitions section of your Handbook. Eligibility, area of cover and pre-existing medical conditions Cover under this plan is only available if your Aetna Pioneer or Summit plan is in force. The maximum age at entry is 79. For full eligibility details, see your Handbook. This plan provides worldwide cover. This plan does not provide cover for medical conditions that exist within the 24-month period before the date of booking a trip, or your date of joining, whichever is later. See exclusion ET2 in your Handbook for more information Aetna Travel add-on plan premiums Yearly premiums Age USD HKD 0-21 USD 80 HKD USD 215 HKD 1,669 The premiums shown do not include Insurance Premium Tax (IPT) or other local taxes. If any taxes apply in your country of residence, these will be added to your premiums. For premiums including any applicable taxes, please contact us for a full quotation. If you are over 79 at your plan renewal date, we will give you a quotation for your renewal premium. 5
6 Stay connected to Aetna International Visit Follow Like Starr is a trademark of Starr International Insurance (Asia) Limited and is protected throughout the world by trademark registrations and treaties. Aetna is a trademark of Aetna Inc. and is protected throughout the world by trademark registrations and treaties. Starr/Aetna does not provide care or guarantee access to health services. Not all health services are covered, and coverage is subject to applicable laws and regulations, including economic and trade sanctions. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a health care professional. See plan documents for a complete description of benefits, exclusions, limitations and conditions of cover. Information is believed to be accurate as of the production date; however, it is subject to change. For more information, refer to No warranty or representation is given, whether expressed or implied, as to the completeness and/or accuracy of the information contained in this document and accordingly the information given is for guidance purposes only. You are requested to verify the above information before you act upon it. You should not rely on such information and should seek your own independent legal advice. We will not be liable for any loss and damage, whether direct or indirect, from your use of the information and the materials contained therein. If coverage provided by this policy violates or will violate any United States (US), United Nations (UN), European Union (EU) or other applicable economic or trade sanctions, the coverage is immediately considered invalid. For example, Starr/Aenta companies cannot make payments or reimburse for health care or other claims or services if it violates a financial sanction regulation. This includes sanctions related to a blocked person or entity, or a country under sanction by the US, unless permitted under a valid written Office of Foreign Assets Control (OFAC) license. For more information on OFAC, visit Policies under this plan issued in Hong Kong by Starr International Insurance (Asia) Limited, registered address Suite 1901, 19F Central Plaza, 18 Harbour Road, Wanchai, Hong Kong, are administered by Aetna Global Benefits (Asia Pacific) Limited, an Aetna Company, registered address Suite , Berkshire House, 25 Westlands Road, Quarry Bay, Hong Kong, Insurance Agency Registration No Important: This is a non-us insurance product that does not comply with the US Patient Protection and Affordable Care Act (PPACA). This product may not qualify as minimum essential coverage (MEC), and therefore may not satisfy the requirements, if applicable to you and your dependants, of the Individual Shared Responsibility Provision (individual mandate) of PPACA. Failure to maintain MEC can result in US tax exposure. You may wish to consult with your legal, tax or other professional advisor for further information. This is only applicable to certain eligible US taxpayers Aetna Inc. M E
Aetna Travel Benefits Schedule
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