Who is the Plan Administrator?

HCC Medical Insurance Services, headquartered in Indianapolis, Indiana, is a full service organization offering a comprehensive portfolio of insurance products designed specifically to address the insurance needs of consumers worldwide. HCCMIS is a subsidiary of HCC Insurance Holdings, Inc. (HCC), which is a leading international specialty insurance group headquartered in Houston, Texas. HCC has assets of more than $8.6 billion, shareholders’ equity in excess of $2.7 billion and is rated ‘AA’ (Very Strong) by Standard & Poor’s, ‘AA’ (Very Strong) by Fitch Ratings and ‘A+’ (Superior) by A.M. Best Company.

Who is the Insurer?

The CitizenSecure^SM  Series is insured by Lloyd’s. Lloyd's is the largest and oldest insurance market in the world and is rated ‘A’ (Excellent) by A.M. Best Company and ‘A+’ (Strong) by Standard and Poor’s. Lloyd’s provides financial strength and security that is unparalleled in the worldwide insurance market. Lloyd’s is recognized as a market leader in the accident and health insurance arena and is well-known for its innovative products and services. Presently, Lloyd’s provides accident and health insurance to millions of individuals in almost every country of the world.

Which Coverage Area is Right for Me?

CitizenSecure^SM offers two coverage areas: including the US and Canada and excluding the US and Canada. If you desire worldwide coverage, select the "Including the US and Canada" option. If you do not need or desire coverage in the US or Canada, you may obtain lower premiums by selecting the "Excluding the US and Canada" option.

Am I Eligible for CitizenSecure^SM?

CitizenSecure^SM is available to citizens of all countries of the world who are at least age 14 days and not older than age 74. If you are a US citizen, you must reside outside the US, or plan to depart the US within 30 days of the effective date. If you are a US citizen, you must also reside outside the US for at least 6 months within each Certificate Period. Citizens of other countries may reside anywhere, including their country of citizenship. Optional Term Life Insurance is not available to residents of the US, regardless of your citizenship.

Is Coverage Under CitizenSecure^SM Renewable?

Yes. CitizenSecure^SM products are annually renewable. There are no medical questions at renewal. Renewal is only subject to your continued eligibility and timely payment of premiums. Your renewal premium will be the same as all persons of the same Certificate origination year, age and gender. If you purchase coverage before you reach the age of 65, and maintain coverage continuously for 10 years, subject to continued eligibility, you will automatically be eligible to apply for the CitizenSecure^SM Senior Plan with no medical questions.

CitizenSecure^SM Senior Plan

Eligibility for the standard CitizenSecure^SM plan ends at age 75, but for those members who joined before age 65 and have maintained coverage for at least 10 years, the CitizenSecure^SM Senior Plan is available with no medical questions. The CitizenSecure^SM Senior Plan offers many of the same great benefits and limits as the standard CitizenSecure^SM plan. The Senior Plan deductibles available are $5,000, $7,500, and $10,000. On the Senior plan, the Overall Maximum Limit is reduced to $1 million. Additionally, the Human Organ Transplant and Emergency Medical Evacuation benefits are deleted.

How Do I Apply for CitizenSecure^SM?

HCC Medical Insurance Services ® offers a variety of easy ways for you to apply for coverage.

Applying Online, by Fax, or by Mail
Complete the Application for Insurance and send it with your initial premium payment to your agent or to HCC Medical Insurance Services ®. Remember, your Application will become a permanent part of your record as well as part of your Certificate of Coverage. Answer each question thoroughly and legibly. You may attach additional sheets if necessary.

Within five business days of receipt of your Application, you will be informed of whether your Application has been accepted or of any additional information required for continuing the evaluation of your Application. If your Application is accepted, you will be informed of the effective date of coverage, and a fulfillment kit will be sent via mail containing your Certificate of Coverage, an identification card, a Claimant's Statement, and instructions on how to use your insurance. In the event that your Application is not accepted, HCC Medical Insurance Services ® will promptly refund your premium.

Applying by Phone
You may apply over the phone by calling 1-800-388-6580 (toll free) or 1-239-591-1715. The underwriting representative will gather your personal details, benefit choices, and medical history and may be able to notify you immediately of acceptance or additional information needed. In some cases, your application may be pended for additional medical review. Within two business days following any telephone application, an e-mail will be sent to you regarding the status of your application and requesting verification of your application. If you do not meet the eligibility guidelines based on information collected during the call, you will be advised immediately.

What Should I Expect During the Underwriting Process?
CitizenSecure^SM is a medically underwritten plan, which means that your family's medical status and history will be used to determine your eligibility for coverage. When Underwriting reviews your Application, they will evaluate the medical information that you provide and determine whether coverage can be issued and if Riders are necessary. These Riders allow Underwriting to issue a Certificate by excluding coverage for specified conditions.

Additionally, your premium may be impacted by your tobacco and alcohol use, body build, and family history details. If additional premium is due, you will be notified after a medical underwriter has reviewed the application.

Preferred Provider Network (PPO)

Coinsurance will be waived for expenses incurred in the US within our direct-pay PPO. Simply present your identification card at the provider's office so that they may contact us to verify benefits and billing information. For your convenience, HCC Medical Insurance Services ® also offers an international network. Both networks are searchable through Client Zone, which is accessible with your Certificate number and date of birth once coverage has been approved.

How Do I File a Claim?

Filing a claim is easy. Once your Application is accepted, you will receive a kit which contains Claimant's Statement and Authorization forms. Just complete this Claimant's Statement and Authorization form, attach original, itemized bills, and forward them to HCC Medical Insurance Services ®. Be sure to complete your Claimant's Statement entirely and sign it. If you have already paid certain expenses, attach copies of your payment receipts. You will be reimbursed for eligible medical or dental expenses. In many cases, HCC Medical Insurance Services ® will make payments directly to the hospital or physician that treated you. Remember, you are responsible for the deductible, coinsurance, and any ineligible charges.

Pre-certification

CitizenSecure^SM plans require Pre-certification, which simply means that you must contact HCC Medical Insurance Services ® as soon as possible before a planned hospitalization or surgical procedure, within 48 hours of an emergency hospital admission, or within the first 90 days of pregnancy. Pre-certification allows us to establish contact and make payment arrangements with your providers, negotiate discounts which will benefit both you and us, pre-arrange future care, and plan for your claim. Pre-certification helps us help you.

What Are the Plan Features?

Emergency Medical Evacuation:
CitizenSecure^SM provides coverage for Emergency Medical Evacuation to the nearest medical facility qualified to treat your life-threatening condition or potential loss of limb. All Emergency Medical Evacuations must be approved in advance and coordinated by HCC Medical Insurance Services ®. Emergency Medical Evacuations provide you with access to care when you need it most. HCC Medical Insurance Services ® is available 24 hours a day, 7 days a week, to approve and coordinate Emergency Medical Evacuations.

Emergency Reunion:
In the event of a covered Emergency Medical Evacuation, CitizenSecure^SM will provide the following benefits: the cost of an economy round-trip air and/or ground ticket for one of your Relatives (parent, spouse, sibling or child age 18 or above) for travel to the area where you are hospitalized following an Emergency Medical Evacuation and reasonable expenses for lodging and meals for your Relative for a period not to exceed 15 days.

Repatriation of Remains:
In the event of a covered Injury or Illness resulting in your death, the plan will provide the following benefit: air and/or ground transportation of bodily remains or ashes to the area of your principal residence and reasonable cost of preparation of the remains necessary for transportation.

Wellness:
After 12 months of continuous coverage, you may be eligible for Wellness benefits that are not subject to the Deductible. If you are at least 30 years of age, you will be entitled to the following Wellness benefit: $250 per Certificate Period for a Routine Physical Exam, including OB/GYN visits for females. Additionally, females who are at least 40 years of age will be entitled to the following benefit: $100 per Certificate Period for a screening mammogram. If you are under the age of 19, you will be entitled to the following Wellness benefit: $50 per visit (including immunizations) with a maximum of three visits per Certificate Period.

Optional Dental Insurance:
The Optional Dental Rider provides important benefits for families including Preventative care for children and Basic and Major Dental Benefits for both children and adults. Preventative Benefits include routine oral exams and x-rays, cleaning and fluoride treatments. Basic Benefits include periodontics, endodontics, extractions and fillings. Major Benefits include crowns, bridges and dentures. The CitizenSecure^SM Optional Dental Rider is a must for families as well as individuals. Coverage is provided worldwide at your choice of dentists.

Optional Sports Rider:
The Optional Sports Rider is a must-have addition for your extreme sports lifestyle. Whether your interests include mountaineering, skydiving, or whitewater rafting, electing the Sports Rider option will add coverage up to a lifetime maximum of $25,000 for these activities excluded by the standard plan. Coverage for Contact Sports, such as soccer or hockey, is added up to a lifetime maximum of $5,000. The Sports Rider adds coverage for sports and athletics except those activities engaged in for wage, reward, or profit.

Pre-existing Conditions:
If your Pre-existing Conditions have been fully disclosed on your Application and not excluded or restricted by a Rider or any other provision of your Certificate, your Pre-existing Conditions are covered the same as any other Illness or Injury as of your effective date. Pre-existing Conditions include any Injury, Illness or Mental Health Disorder that existed at or prior to your initial effective date, including chronic or recurring conditions.

What Are the Exclusions and Limitations?
The following charges, treatments, care, services, supplies and/or conditions are excluded from coverage:

• Charges not Incurred during the Certificate period

• Services or treatment payable by another insurance or government

• Substance Abuse

• Charges which exceed Usual, Reasonable and Customary

• Investigational or experimental Surgeries or treatment

• Custodial, Educational or Rehabilitative Care

• Weight modification

• Cosmetic surgery, unless reconstructive surgery is directly related to a covered Injury or Illness

• Charges for use of Emergency Room for treatment of Illness unless the patient is directly admitted to the Hospital as Inpatient for further treatment of that Illness

• Individuals HIV+ at effective date

• Charges relating to congenital conditions

• Drugs or treatment for sexual dysfunction

• Drugs or treatment to promote or prevent conception

• Devices or procedures to correct sight or hearing

• Self-inflicted Injury or Illness

• Foot care, unless related to a covered accidental Injury

• Treatment or supplies not ordered by a Physician or not Medically Necessary

• Organ transplants, except for Covered Transplants

• Speech, acupuncture, occupational or sleep therapy

• Acts of Terrorism, war, insurrection, riot or any variation thereof

• Dental Treatment, except emergency treatment following a covered Accident, or unless Dental Rider is purchased

The following are excluded from the Optional Dental Rider:

• Orthodontia

• Sealants, Bleaching and oral hygiene expenses

This is a summary of the exclusions contained in the Certificate of Insurance. See the Certificate of Insurance for a complete list of exclusions.

Special Illness Exclusion:
The following conditions which manifest themselves within the first 180 days of coverage are excluded: Any condition of the breast, prostate, the reproductive system, tonsils, adenoids, hemorrhoids, hernia, gallstones, kidney stones, glaucoma, cataracts, disk disease, varicose veins, all types of cysts, arthritis, and repetitive motion disorders, and any disorder or disease of the skin.

CitizenSecure^SM Assistance Services:

All Assistance Services are available to you 24 hours a day, 7 days a week while your CitizenSecure^SM plan is in effect.

Pre-Trip Health and Safety Advisories (available after your purchase of CitizenSecure^SM and before your departure) - Call us for current passport, visa, inoculation and vaccine requirements, as well as up-to-date travel safety advisories.

Livetravel Services - We will make emergency travel and itinerary changes for you including rebooking flights, hotel reservations and ground transportation arrangements.

BagTrak - We are the industry leaders in tracking lost checked baggage. We will help you locate your lost checked baggage and deliver it to you anywhere in the world.

Emergency Message Relay - We will relay messages to your family, friends and co-workers, helping you to maintain contact during an emergency.

Emergency Cash Transfers - We will assist you in arranging and obtaining cash transfers anywhere in the world.

CitizenSecure^SM Assistance Services also include:

• Medical referrals

• Up-to-the-minute travel medical advisories

• Assistance with prescription drug replacement

• Dispatch of a doctor or specialist

• Emergency travel arrangements for family members

• Lost passport or travel documents assistance

• Embassy and consulate referrals

• Legal and accounting referrals

• Bail bond assistance

• Translation and interpretation assistance

CitizenSecure^SM Assistance Services are not insurance benefits, and provision of any CitizenSecure^SM Assistance Service is not a guarantee of any other benefit under CitizenSecure^SM.

Apply online 24/7 at www.missionaryhealthplans.com

e-mail us at info@missionaryhealthplans.com
or call (800) 388-6580