Gallagher Student Health and Special Risk

Services through the UnitedHealthcare Global Emergency Services Program are included in the benefits available to students and their covered dependents insured through the Student Health Insurance Plan.

Claims for reimbursement of services not provided by UnitedHealthcare Global Emergency Services will not be accepted. Reimbursement for medical services received should be submited to the health insurance claims administrator and will be subject to the policy limits of the Student Health Insuarnce Plan.

STUDENTS GOING ABROAD

For students studying or traveling abroad, the Student Health Insurance Plan provides worldwide Travel Assistance Services to you or your covered dependents through UnitedHealthcare Global Emergency Services.

The requirements to receive these services are as follows:

International Students, insured spouse and insured minor child(ren): you are eligible to receive UnitedHealthcare Global Emergency services, except in your home country.

Domestic Students, insured spouse and insured minor child(ren): you are eligible for UnitedHealthcare Global services when 100 miles or more away from your campus address and 100 miles or more away from their permanent home address or while participating in a Study Abroad program.

All services must be arranged and provided by Global Emergency Services , any services not arranged by Global Emergency Services will not be considered for payment.

The Emergency Medical Evacuation services are not meant to be used in lieu of or replace local emergency services such as an ambulance requested through emergency 911 telephone assistance. All services must be arranged and provided by UnitedHealthcare Global; any services not arranged by UnitedHealthcare Global will not be considered for payment. If the condition is an emergency, you should go immediately to the nearest physician or hospital without delay and then contact the 24-hour Emergency Response Center. UnitedHealthcare Global will then take the appropriate action to assist you and monitor your care until the situation is resolved.

Key Services include:

• Transfer of Insurance Information to Medical Providers
• Monitoring of Treatment
• Transfer of Medical Records
• Medication, Vaccine
• Worldwide Medical and Dental Referrals
• Dispatch of Doctors/Specialists
• Emergency Medical Evacuation
• Facilitation of Hospital Admittance up to $5,000 payment
• Transportation to Join a Hospitalized Participant
• Transportation After Stabilization
• Coordinate the replacement of Corrective Lenses and Medical Devices
• Emergency Travel Arrangements
• Hotel Arrangements for Convalescence
• Continuous Updates to Family and Home Physician
• Return of Dependent Children
• Replacement of Lost or Stole Travel Documents
• Repatriation of Mortal Remains
• Worldwide Destination Intelligence Destination Profiles
• Legal Referral
• Transfer of Funds
• Message Transmittals
• Translation Services

Please visit www.uhcsr.com/UHCGlobal for the UnitedHealthcare Global brochure which includes service descriptions and program exclusions and limitations.

To access service, please call:
(800) 527-0218 Toll-free within the United States
(410) 453-6330 Collect outside the United States
Services are also accessible via email UHCGlobal.com.

When calling the UnitedHealthcare Global Operations Center, please be prepared to provide:

1. Caller's name, telephone and (if possible) fax number, and relationship to the patient;
2. Patient's name, age, sex and UnitedHealthcare Global ID number as listed on your Medical ID card;
3. Description of patient's condition;
4. Name, location, and telephone number of hospital, if applicable;
5. Name and telephone number of the attending physician; and
6. Information of where the physician can be immediately reached.

UnitedHealthcare Global is not travel or medical insurance but a service provider for emergency medical assistance services. All medical costs incurred should be submitted to your health plan and are subject to the policy limits of your health coverage. All assistance services must be arranged and provided by UnitedHealthcare Global. Claims for reimbursement of services not provided by UnitedHealthcare Global will not be accepted. Please refer to the UnitedHealthcare Global information in My Account at www.uhcsr.com/MyAccount for additional information, including limitations and exclusions.