bupa secure care premium rates - ASA International Insurance

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BUPA SECURE CARE PREMIUM RATES, EFFECTIVE JANUARY 1, 2013ZONEsHOW IS THE PREMIUM PAID?Bupa must receive payment before the coverage can take effect.Please submit payment with your application. You can chooseamong the following payment options:Online payment by credit card through our websitewww.bupalatinamerica.comCredit card MasterCard, VISA, American Express, or Diners ClubPersonal check in U.S. dollars drawn on an American bank,cashier’s check, money order, traveler’s checkBank transfer:Procedure for ACH’sWells Fargo Bank200 South Biscayne Blvd, FL6011Miami, FL 33131Account # 2000037371881ABA # 067006432Account Name: Bupa Worldwide Premium TrustReference: Policyholder Name and Policy NumberProcedure for domestic wire transfersWells Fargo Bank200 South Biscayne Blvd, FL6011Miami, FL 33131Account # 2000037371881ABA # 121000248Account Name: Bupa Worldwide Premium TrustReference: Policyholder Name and Policy NumberProcedure for international wire transfersWells Fargo Bank200 South Biscayne Blvd, FL6011Miami, FL 33131Account # 2000037371881ABA # 121000248CHIPS # 0407SWIFT # WFBIUS6SAccount Name: Bupa Worldwide Premium TrustReference: Policyholder Name and Policy Number(a)Deductible Plan 1 (US$0/US$1,000) is only available for renewals as of January 1, 2013.10Country
BUPA SECURE CARE PREMIUM RATES, EFFECTIVE JANUARY 1, 2013ZONEs7001 S.W. 97th AvenueMiami, Florida 33173Tel. +1 (305) 398 7400Fax +1 (305) 275 8484www.bupalatinamerica.combupa@bupalatinamerica.com(a)Deductible Plan 1 (US$0/US$1,000) is only available for renewals as of January 1, 2013.CountryPR-SEC 2013 ENG11
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