STUDENT HEALTH INSURANCE INFORMATION 2011-2012
Dear Student and Host Family,
Below you will find information regarding student insurance. Important phone numbers, addresses and web sites for
information and claims are included below. The student will be covered under one of the following policies: Elite L -
IEGE000173261 or Supreme L - IEGS 000173262. Student specific policy information can be found on the insurance
ID card given to each student. Additional information can be found in the insurance flyers/booklets that have been
sent to all students.
For additional copies of insurance flyers/booklets, claim forms and/or new insurance ID cards please log into www.esecutive.com/MyInsurance or contact your local Area Representative or the ISE Headquarters at 1-800-766-4656.
Host families should not use their own medical insurance when taking a student to a medical provider.
Global Secutive ALL CLAIMS MUST BE FILED WITHIN 90 DAYS OF TREATMENT
Global Secutive is the ISE Insurance Agent, and the insurance coverage is provided by the IMG / First Health Network in the U.S. Please refer to the Student Insurance ID Card and Insurance Brochure for specific details of your plan coverage.
Please try to select a medical provider who accepts First Health Network coverage. A provider directory can be found at www.esecutive.com/MyInsurance. The medical provider will then be able to file your claim directly with IMG. If you visit a medical provider and pay for the service, you must send a claim form and original receipts to the address below for reimbursement.
The most direct sources of assistance are as follows:
REIMBURSEMENT OF CLAIMS CUSTOMER CARE CENTER
Send claim form and receipts to: Phone: 1-800-628-4664 (toll free)
International Medical Group
P.O. Box 88500 24-Hour Medical Emergency Number:
Indianapolis, IN 46208-0500 Phone: 1-800-628-4664 (toll free)
Email:insurance@imglobal.com
Web site:www.esecutive.com/MyInsurance
If you have received treatment and need to be reimbursed for out-of-pocket medical expenses, complete the Claim Form and submit your original itemized bills and paid receipts within 90 days. Claims submitted after 90 days will not be reimbursed.
It is recommended to always call for pre-certification prior to seeing a doctor. If you go to the emergency room, the student, the host family, or the attending physician should call the Customer Care Center as soon as possible.
VERY IMPORTANT - A $250 deductible, per diagnosis, will be applied for emergency room visits that are non-emergency related.
