The following is a brief description of the Benefits of the Diplomat L.T. Health program. A complete description is contained in the plan Summary, which is mailed or faxed to you upon your enrollment in the program. Please take a moment to familiarize yourself with Pre-Existing Conditions & Exclusion provisions prior to applying for this policy.

Eligibility:
Diplomat LT provides Accident and Sickness medical coverage, Accidental Death and Dismemberment benefits and Travel Assistance to any individual(s) while traveling outside of their Home Country. Coverage may be available to you, your spouse, and any unmarried dependent children ages 14 days to 18 years.

Period of Coverage:
The minimum initial period of coverage that can be purchased under this plan is 3 months, the maximum is 12 months. Additional coverage may be available for up to 12 months at a time, to a maximum of 36 consecutive months.

Policy Maximums:
Lifetime policy maximums for Accident and Sickness Medical Coverage are:

Persons Traveling In The USA		Persons Traveling Outside The USA
Plan A $500,000 U.S. Plan B $1,000,000 U.S.		Plan C $500,000 U.S. Plan D $1,000,000 U.S.

($50,000 Maximum benefit for persons 70 - 79; $10,000 Maximum benefit for persons 80+)

24 Hour Worldwide Assistance:
Is provided to all insureds and is available 24 hours a day, 7 days a week Toll-Free.

Emergency Medical Evacuation:
Maximum per person is $50,000 not subject to deductible and co-insurance.

Emergency Reunion:
$10,000 maximum, not subject to deductible and co-insurance.

Local Ambulance Expense:
Up to selected policy maximum

Hospital Room and Board:
Average semi-private room rate up to selected policy maximum.

Intensive Care:
2x average semi-private room rate

Outpatient Medical Expense:
Usual and Customary Rates (UCR) up to selected policy maximum.

Accidental Death & Dismemberment:
$25,000 Principal Sum.

Repatriation of Remains:
$20,000 maximum, not subject to deductible and co-insurance.

Deductibles:
$250, $500, $1,000 & $2,500
(per person per policy period. Maximum of 3 per family)