bupa secure care premium rates - ASA International Insurance

BUPA SECURE CARE PREMIUM RATES, EFFECTIVE JANUARY 1, 2013ZONEsAdministrative notes• Rates are in U.S. dollars and don’t include taxes.• An annual US$75 administration fee per policy applies.• One deductible applies per insured, per policy year up to amaximum of the out-of-country deductible. If the in-countrydeductible has already been met, and treatment is later receivedout of country, the difference between both deductibles willbe the insured’s responsibility. A maximum of two deductiblesper policy, per policy year applies, up to a maximum amountof two out-of-country deductibles.• Maximum age to apply: 74 years old.• Premium rates are based on the country of residence. Seeseparate premium rates for Puerto Rico and the U.S. VirginIslands.• Available payment modes: annually, semiannually andquarterly.• The insurer, USA Medical Services, and/or any of theirapplicable related subsidiaries and affiliates will not engagein any transactions with any parties or in any countrieswhere otherwise prohibited by the laws in the United Statesof America. Please contact USA Medical Services for moreinformation about this restriction.• Bupa reserves the right to correct any errors or omissions.(a)Deductible Plan 1 (US$0/US$1,000) is only available for renewals as of January 1, 2013.Country1