Atlas Premium America

High end travel medical insurance for USA

5 Days to 364 Days

The Atlas Premium America plan is available almost anywhere you may travel internationally for vacation, study abroad, business, and mission work. Atlas Premium America provides the highest levels coverage among the Atlas plans.

What Does Atlas Premium America Cover?

International Coverage

Emergency Medical Evacuation and Emergency Reunion

Would you know what to do if you found yourself in a life-threatening situation far from home? We are experienced in arranging emergency medical evacuations. Atlas Premium America covers eligible expenses necessary to transport you to the nearest medical facility qualified to treat your life-threatening condition. We also understand the importance of family support in these difficult situations. Atlas Premium America will also cover the transportation, lodging, and meal costs for a relative to join you after a covered emergency medical evacuation, up to the lifetime limit.

Repatriation of Remains

What would your family do if disaster struck while you were away from home? The death of a loved one is never easy, no matter the circumstances. In the unfortunate event of your death while traveling abroad, the administrator will arrange for and cover eligible costs associated with the repatriation of your remains.

Return of Minor Children

If you are expected to be hospitalized for more than 36 hours due to a covered injury or illness and covered children under 18 years of age will be left unattended as a result, Atlas Premium America will cover the transportation cost for the children to return home.

Terrorism

In these turbulent times, the risk of a terrorist attack is a reality. If you are in the wrong place at the wrong time, and the country or region you're visiting is NOT under a level 3 or higher travel advisory, Atlas Premium America offers coverage for eligible medical expenses resulting from those acts. Coverage excludes countries or regions for which the U.S. Department of State has issued a level 3 ("reconsider travel") or higher travel advisory in the 60 days prior to your arrival date.

Political Evacuation

If, during the coverage period and after your arrival, the U.S. Department of State issues a level 3 or higher travel advisory for your destination country, Atlas Premium America will coordinate your alternate departure arrangements from that country and cover eligible associated costs.

Natural Disaster - Replacement Accommodations

Natural disasters can happen anywhere and at any time. If a natural disaster occurs on your trip, causing you to become displaced from your planned and paid accommodations, Atlas Premium America will provide relief of a maximum of $250 a day for 5 days to help cover the costs of alternative accommodations.

Atlas Premium America* Quality Benefits

Acute Onset of Pre-Existing Conditions

Atlas Premium America provides a limited benefit up to the medical coverage life-time maximum for eligible medical expenses. If you are younger than 80, you may be covered for an acute onset of a **pre-existing condition. This also includes up to a $25,000 lifetime maximum for emergency medical evacuation.

An acute onset of a pre-existing condition is a sudden and unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent care. A pre-existing condition that is a chronic or congenital, or that gradually becomes worse over time, is not acute onset of a pre-existing condition.

The Acute Onset of Pre-existing Condition benefit will only apply if all of the following conditions are met:

  • The Acute onset of a Pre-Existing Condition does not directly or indirectly relate to a chronic condition or congenital condition;
  • Treatment must be obtained within twenty-four (24) hours of the sudden and unexpected outbreak or reoccurrence;
  • You must be under eighty (80) years of age;
  • You must not be traveling against or in disregard of the recommendations, established treatment programs, or medical advice of a physician or other healthcare provider;
  • You must not be traveling with the intent or purpose to seek or obtain treatment for the pre-existing condition;
  • You must be traveling outside your home country

Hospitalization and Outpatient Treatment

If a covered illness or injury requires hospitalization, the plan provides coverage for costs associated with hospitalization, including intensive care unit and outpatient treatment.

Sports

Atlas Premium America includes coverage for eligible injuries and illnesses that could occur while participating in many popular vacation sports - skiing and snowboarding (recreational downhill and/or cross country), snorkeling, water skiing, and others - at no additional cost. Certain extreme sports are excluded from coverage.

Complications of Pregnancy

Atlas Premium America offers coverage for complications of pregnancy during the first 26 weeks of gestation.

Crisis Response

Atlas Premium America offers $100,000 per certificate period to offset costs associated with kidnapping such as ransom, crisis response expenses, and loss of personal belongings. This benefit includes access to the services of Unity Crisis Group for advice, coordination with law enforcement, and negotiations during a kidnapping.

Personal Liability

Atlas Premium America offers $100,000 per certificate period to offset the following types of court-entered eligible judgments or approved settlements incurred by the member:

  • Third-party injury;
  • Damage/loss of a third party's personal property;
  • Damage/loss of a related third party's personal property.

*The description of coverage in these pages is for informational purposes only. Actual coverage will vary based the terms and conditions of the policy issued. The information described herein does not amend or otherwise affect the terms and conditions of any insurance policy issued by the administrator or its affiliates. In the event that a policy is inconsistent with the information described herein, the language of the policy will take precedence.

**Pre-existing condition means any condition injury, illness, sickness, disease, or other physical, medical, mental, or nervous disorder, condition, or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the 2 years prior to the effective date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, treated, or disclosed to us prior to the effective date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising therefrom.

Atlas Premium America Schedule of Benefits and Limits

BenefitLimits
Deductibles$0, $100, $250, $500, $1,000, $2,500, or $5,000 per certificate period.
Overall Maximum Limit Per Certificate PeriodAge 80 or older - $20,000; Age 65 to 79 - $50,000, or $100,000; All others - $50,000, $100,000, $250,000, $500,000, $1,000,000 or $2,000,000.
CoinsuranceWe will pay 100% of eligible expenses after the deductible up to the overall maximum limit.
Eligible expenses are subject to deductible, coinsurance, overall maximum limit, and are per certificate period unless specifically indicated otherwise.
BenefitLimits
Hospital Room and BoardAverage semi-private room rate, including nursing services.
Local AmbulanceUsual, reasonable and customary charges, when covered illness or injury results in hospitalization as inpatient.
Intensive Care UnitUp to the overall maximum limit.
Emergency Room Co-paymentClaims incurred in the U.S.
The member shall be responsible for a $200 co-payment for each use of emergency room for an Illness unless the member is admitted to the hospital.
There will be no co-payment for emergency room treatment of an injury.

Claims incurred outside the U.S.
No co-payment
Urgent Care Center Co-paymentClaims incurred in the U.S.
For each visit, you shall be responsible for a $15 co-payment. (not subject to deductible)
- Co-payment waived for members with a $0 deductible.

Claims incurred outside the U.S.
No co-payment
Hospital Indemnity$100 per day of inpatient hospitalization (not subject to deductible).
Acute Onset of Pre-existing Condition
See benefit description
Up to the overall maximum limit
Up to $25,000 lifetime maximum for Emergency Medical Evacuation.
TerrorismUp to $50,000 lifetime maximum, eligible medical expenses only.
Emergency Dental (acute onset of pain)Up to $300 (not subject to deductible).
Emergency Eye Exam for a Covered LossUp to $150. $50 deductible per occurrence (plan deductible is waived).
Outpatient Physical Therapy and Chiropractic CareUp to $50 maximum per day. Must be ordered in advance by a physician.
All Other Eligible Medical ExpensesUp to the overall maximum limit.
Emergency Travel BenefitsLimits
Emergency Medical EvacuationUp to $1,000,000 lifetime maximum, except as provided under acute onset of pre-existing condition (not subject to deductible or overall maximum limit).
Return of Minor ChildrenUp to $50,000 (not subject to deductible).
Pet ReturnUp to $1,000 (not subject to deductible).
Repatriation of Remains Equal to the elected overall maximum limit (not subject to deductible or coinsurance).
This limit is for this benefit only and is not included in or subject to the overall maximum limit.
Emergency ReunionUp to $150,000, subject to a maximum of 15 days (not subject to deductible).
Natural Disaster - Replacement AccommodationsUp to $500 a day for 5 days (not subject to deductible).
Emergency Quarantine Indemnity - COVID-19
(Only available outside your home country.)
$50 a day for up to 10 days - (not subject to deductible)
Proof of quarantine mandated by a physician or governmental authority required. Quarantine must be due to you testing positive for COVID-19/SARS-CoV2 or being symptomatic and waiting on diagnostic test results.
Trip InterruptionUp to $15,000 (not subject to deductible).
Trip DelayUp to $200 a day for up to 2 days after a 12-hour delay period requiring an unplanned overnight stay (not subject to deductible).
Lost Checked LuggageUp to $2,000 (not subject to deductible).
Lost or Stolen Passport/Travel VisaUp to $100 (not subject to deductible).
Political Evacuation Up to $150,000 lifetime maximum (not subject to deductible).
Accidental Death and Dismemberment - (excludes loss due to Common Carrier Accident)$250,000 maximum benefit for any one family or group (not subject to deductible or overall maximum limit).
      Members up to age 18 Lifetime max. - $5,000; Death - $5,000; Loss of 2 limbs - $5,000; Loss of 1 limb - $2,500.
      Members age 18 through 69Lifetime max. - $100,000; Death - $100,000; Loss of 2 limbs - $100,000; Loss of 1 limb - $50,000.
      Members age 70 through 74Lifetime max. - $12,500; Death - $12,500; Loss of 2 limbs - $12,500; Loss of 1 limb - $6,250.
      Members age 75 and olderLifetime max. - $6,250; Death - $6,250; Loss of 2 limbs - $6,250; Loss of 1 limb - $3,125.
Common Carrier Accidental Death ($250,000 maximum benefit per any one family or group) Up to age 18 - $10,000 per member;
Age 18 to 69 - $100,000 per member;
Age 70 to 74 - $25,000 per member;
Age 75 and older - $12,500.
(Not subject to deductible, or overall maximum limit).
Crisis Response - Ransom, Personal Belongings, and Crisis Response Fees and Expenses Not subject to deductible or overall maximum limit.
Up to age 18 - $10,000 per member;
Age 18 to 69 - $100,000 per member;
Age 70 to 74 - $25,000 per member;
Age 75 and older - $12,500.
Personal LiabilityUp to:
$100,000 lifetime maximum
$100,000 third person injury
$100,000 third person property
$2,500 related third person property
(not subject to deductible, or overall maximum limit)
Border Entry ProtectionUp to $500 if traveling on a valid B-2 visa and denied entrance at the U.S. border (not subject to deductible)
Bedside VisitUp to $1,500 (not subject to deductible)
Local Burial or CremationUp to $5,000 lifetime maximum (not subject to deductible).

Rates

Atlas Premium America ‐ For Non‐U.S. Citizens traveling to the U.S.

$0 Deductible
Maximum Limit$50,000$100,000$250,000$500,000$1,000,000$2,000,000
AgeDailyDailyDailyDailyDailyDaily
14d-17y$3.64$4.24$4.45$4.88$5.25$6.25
18-29$4.62$5.21$5.45$5.84$6.22$7.24
30-39$4.95$5.95$6.55$6.31$6.65$7.82
40-49$6.33$7.26$7.85$8.19$8.92$10.63
50-59$9.30$10.96$12.87$13.09$13.84$16.68
60-64$10.62$13.01$16.35$16.09$17.02$20.62
65-69$12.08$14.57N/AN/AN/AN/A
70-79*$16.66$20.59N/AN/AN/AN/A
80+**$35.23N/AN/AN/AN/AN/A

*$100,000 Maximum Limit for ages 70-79; **$20,000 Maximum Limit for age 80 and over.

$100 Deductible
Maximum Limit$50,000$100,000$250,000$500,000$1,000,000$2,000,000
AgeDailyDailyDailyDailyDailyDaily
14d-17y$3.34$3.87$4.07$4.43$4.76$5.65
18-29$4.34$4.85$5.08$5.39$5.73$6.63
30-39$4.59$5.48$6.01$5.80$6.07$7.11
40-49$5.81$6.63$7.15$7.44$8.07$9.59
50-59$8.47$9.89$11.60$11.77$12.44$14.95
60-64$9.63$11.72$14.66$14.42$15.24$18.40
65-69$10.93$13.12N/AN/AN/AN/A
70-79*$14.84$18.28N/AN/AN/AN/A
80+**$31.15N/AN/AN/AN/AN/A

*$100,000 Maximum Limit for ages 70-79; **$20,000 Maximum Limit for age 80 and over.

$250 Deductible
Maximum Limit$50,000$100,000$250,000$500,000$1,000,000$2,000,000
AgeDailyDailyDailyDailyDailyDaily
14d-17y$2.95$3.37$3.54$3.84$4.12$4.89
18-29$3.87$4.29$4.47$4.73$5.04$5.80
30-39$4.06$4.80$5.23$5.06$5.29$6.19
40-49$5.08$5.78$6.21$6.45$6.99$8.26
50-59$7.34$8.55$9.98$10.12$10.68$12.81
60-64$8.34$10.11$12.57$12.35$13.06$15.72
65-69$9.40$11.25N/AN/AN/AN/A
70-79*$12.62$15.56N/AN/AN/AN/A
80+**$26.41N/AN/AN/AN/AN/A

*$100,000 Maximum Limit for ages 70-79; **$20,000 Maximum Limit for age 80 and over.

$500 Deductible
Maximum Limit$50,000$100,000$250,000$500,000$1,000,000$2,000,000
AgeDailyDailyDailyDailyDailyDaily
14d-17y$2.85$3.25$3.41$3.68$3.95$4.64
18-29$3.81$4.19$4.38$4.61$4.88$5.60
30-39$3.95$4.66$5.06$4.88$5.11$5.93
40-49$4.91$5.56$5.94$6.18$6.67$7.86
50-59$7.03$8.16$9.49$9.58$10.13$12.10
60-64$7.94$9.58$11.88$11.68$12.32$14.82
65-69$8.98$10.67N/AN/AN/AN/A
70-79*$11.86$14.58N/AN/AN/AN/A
80+**$24.62N/AN/AN/AN/AN/A

*$100,000 Maximum Limit for ages 70-79; **$20,000 Maximum Limit for age 80 and over.

$1,000 Deductible
Maximum Limit$50,000$100,000$250,000$500,000$1,000,000$2,000,000
AgeDailyDailyDailyDailyDailyDaily
14d-17y$2.64$2.99$3.11$3.34$3.59$4.19
18-29$3.58$3.91$4.06$4.26$4.49$5.13
30-39$3.68$4.30$4.63$4.48$4.66$5.40
40-49$4.52$5.09$5.42$5.60$6.05$7.10
50-59$6.39$7.37$8.53$8.62$9.09$10.83
60-64$7.19$8.65$10.63$10.45$11.01$13.19
65-69$8.10$9.59N/AN/AN/AN/A
70-79*$10.56$12.90N/AN/AN/AN/A
80+**$21.69N/AN/AN/AN/AN/A

*$100,000 Maximum Limit for ages 70-79; **$20,000 Maximum Limit for age 80 and over.

$2,500 Deductible
Maximum Limit$50,000$100,000$250,000$500,000$1,000,000$2,000,000
AgeDailyDailyDailyDailyDailyDaily
14d-17y$2.47$2.76$2.86$3.08$3.27$3.81
18-29$3.39$3.70$3.82$3.99$4.17$4.75
30-39$3.46$3.99$4.31$4.14$4.33$4.97
40-49$4.20$4.69$4.99$5.14$5.53$6.45
50-59$5.86$6.72$7.73$7.81$8.21$9.73
60-64$6.58$7.83$9.58$9.40$9.89$11.82
65-69$7.37$8.68N/AN/AN/AN/A
70-79*$9.40$11.49N/AN/AN/AN/A
80+**$19.15N/AN/AN/AN/AN/A

*$100,000 Maximum Limit for ages 70-79; **$20,000 Maximum Limit for age 80 and over.

$5,000 Deductible
Maximum Limit$50,000$100,000$250,000$500,000$1,000,000$2,000,000
AgeDailyDailyDailyDailyDailyDaily
14d-17y$2.13$2.46$2.62$2.82$3.02$3.51
18-29$2.93$3.28$3.49$3.67$3.85$4.40
30-39$2.97$3.56$3.92$3.81$3.99$4.58
40-49$3.61$4.17$4.54$4.73$5.09$5.94
50-59$5.04$6.00$7.05$7.18$7.57$9.00
60-64$5.65$6.99$8.73$8.65$9.13$10.92
65-69$6.34$7.75N/AN/AN/AN/A
70-79*$7.86$9.95N/AN/AN/AN/A
80+**$16.49N/AN/AN/AN/AN/A

*$100,000 Maximum Limit for ages 70-79; **$20,000 Maximum Limit for age 80 and over.
Rates are shown in US dollars and are effective 02/01/2023. Rates are subject to change. Rates will include Surplus Lines taxes and fees when applicable.

If for any reason you wish to cancel your policy, you must submit your cancellation request in writing to us in order to receive a refund or premium. Cancellation requests received after the policy effective date will be subject to the following conditions: 1) a $25 cancellation fee will apply; and 2) only the unused portion of the plan cost will be refunded; and 3) only members who have no claims are eligible for premium refund.

Administrator

WorldTrips
4 Carter Green, Suite 400
Carmel, IN 46032

FOR ADDITIONAL INFORMATION

Xiaolei Yan
Jingshi Road,LuShangGuoao Cheng bldg 6,Suite 2011, Lixia District
Jinan, Shandong  250000
China

Phone: (+86)13121868637
Fax: (+86)53182812155
Website: xiaoleiyan.brokersnexus.com

This insurance is not subject to, and does not provide certain insurance benefits required by the United States' Patient Protection and Affordable Care Act ("PPACA"). PPACA requires certain US citizens or US residents to obtain PPACA compliant health insurance, or "minimum essential coverage." PPACA also requires certain employers to offer PPACA compliant insurance coverage to their employees. Tax penalties may be imposed on U.S. residents or citizens who do not maintain minimum essential coverage, and on certain employers who do not offer PPACA compliant insurance coverage to their employees. In some cases, certain individuals may be deemed to have minimum essential coverage under PPACA even if their insurance coverage does not provide all of the benefits required by PPACA. You should consult your attorney or tax professional to determine whether this policy meets any obligations you may have under PPACA.

The Atlas Series is underwritten by Lloyd's. WorldTrips is a service company and a member of the Tokio Marine HCC group of companies. WorldTrips has authority to enter into contracts of insurance on behalf of the Lloyd's underwriting members of Lloyd's Syndicate 4141, which is managed by HCC Underwriting Agency LTD.

Version: KHE2FFFYH6SP-971744701-646
02/01/2023

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