NORTHWESTERN UNIVERSITY
Visiting Scholar Benefits Plan Brochure

Effective July 1, 2003

ELIGIBILITY
The Northwestern University Visiting Scholar Benefits Plan is designed for international visitors to the University and their dependents.

An "Eligible Scholar" means a visitor to Northwestern University who is engaged full-time in international educational activities; is temporarily outside the visitor's home country or country of regular domicile as a non-resident alien in the United States; has a current passport or visa, if required; and has not applied for permanent residency in the United States.

An "Eligible Dependent" means a dependent of an Eligible Scholar who has a current passport or visa; is temporarily outside the dependent's home country or country of regular domicile as a non-resident alien in the United States; has not applied for permanent residency status in the United States; is the Eligible Scholar's lawful spouse or unmarried child (under 21years of age and dependent upon the Eligible Scholar or the scholar's spouse for support and care); resides with the Eligible Scholar; and is enrolled for coverage under this policy at the same time that the Eligible Scholar enrolls. A dependent who does not meet the definition of an Eligible Dependent at the time the Eligible Scholar enrolls may be enrolled within 31 days of the date the dependent first meets the definition of an Eligible Dependent.

COVERAGE PERIOD
Provided an Enrollment Form is completed and proper premium paid, and Eligible Scholar or Eligible Dependent becomes insured upon entry to the United States. Dependent coverage can not become effective prior to the effective date of coverage for the Eligible Scholar.

Coverage will automatically terminate on the earliest of:
1. The date the policy terminates;
2. The last day for which premium has been paid;
3. The date the Eligible Scholar is no longer eligible for coverage;
4. The date the Eligible Scholar departs the United States for his/her home country or country of regular domicile.
5. The date requested by the Eligible Scholar and approved by the Office of Risk Management that is no sooner than 5 days after the Office of Risk Management receives written notice. Any unearned premium will be returned to the sponsoring University Department, but returned premium will only be for the number of FULL months remaining in the unexpired term of coverage.

MEDICAL EXPENSE BENEFITS
Maximum $250,000 Benefit per Cause
Each insured individual has a medical benefit maximum of $250,000 for each covered injury or illness.

Deductible
The deductible is the amount of a covered medical expense that the insured individual must pay. Under this Plan deductibles are as follows:

1. There will be no deductible for covered expenses incurred at the Student Health Service.
2. There will be a $20 deductible for each authorized visit to a physician or clinic outside the Student Health Service pursuant to an authorized referral from a physician at the Student Health Service.
3. There will be a $50 deductible for each injury or illness if the insured scholar does not visit the Student Health Service first for diagnosis and treatment of a covered injury or illness.
4. There will be an additional $50 deductible for treatment of an injury or illness in a hospital emergency room unless the insured scholar is admitted to the hospital directly from the emergency room. See the "Emergency Room Expenses" section below.

Serious Medical Condition Notification
All insured individuals must notify Northwestern University at (847) 491-2113 as soon as the insured individual becomes aware of a serious injury or illness and prior to any hospitalization or surgery. This notification will allow the University to provide the insured individual with names of local preferred physicians and hospitals. Notification will also be used to initiate case management, when appropriate, to facilitate a proper and efficient course of treatment.

Emergency Room Expense
Covered expenses incurred for treatment of an injury or illness in a hospital emergency room will be paid as any other covered hospital expense. However, there will be as $50 deductible charged unless the insured scholar is confined in the Hospital immediately after treatment on the attending physician's direction.

Physiotherapy Expenses
Covered expenses in connection with physiotherapy (as defined below) which are incurred while not confined in a hospital and which are billed by a physician or physiotherapist shall not exceed the maximum amounts shown below. Charges in excess of these maximums will not be included as covered expenses under this Plan. "Physiotherapy" is defined as the treatment of illness or injury by the use of physical means including, but not limited to, air, heat, light, water, electricity, massage, manipulation or active exercise. The maximum physiotherapy benefit per calendar year is $500 and the maximum benefit per office visit is $50 for the first visit and $25 for each visit thereafter.

Pregnancy Benefits
Covered expenses for pregnancy are payable on the same basis as covered expenses for any other illness with regard to an insured scholar or covered spouse. No benefits are payable for any expenses relating to the pregnancy of a dependant child.

Newborn Infants
A newborn child of an insured scholar will automatically be an insured dependant for 31 days from the date of its birth only for covered expenses incurred which are due directly to injury or illness, premature birth or congenital condition which exists at birth. In order to continue coverage of a newborn child beyond the 31st day following the date of birth: (1) notice of the birth must be provided to the Northwestern University Office of Risk Management within 31 days of the date of birth; and (2) the required premium must be received by the Office of Risk Management. If conditions (1) and (2) are not satisfied, coverage of the newborn child, including any extension of benefits, will terminate 31 days from the date of birth.

Intercollegiate/Interscholastic Sports Benefit
Benefits will be paid to a maximum of $10,000 for each injury arising out of practice for or participation in intercollegiate or interscholastic sports.

Medical Evacuation Benefit
Subject to prior approval from the University's Office of Risk Management, as an additional benefit, the Plan will cover, up to a lifetime maximum of $25,000, charges for air evacuation of an injured or ill insured scholar along with a healthcare provider or escort if authorized by the attending physician, to the scholar's home country or country of regular domicile, provided such air evacuation:
1. is upon the attending physician's written certification;
2. result from a covered injury or illness; and
3. does not occur prior to the benefit approval.

Repatriation Benefit
As an additional benefit, the Plan will cover, up to a maximum of $10,000 in the aggregate, reasonable expenses which are incurred in connection with the preparation and transportation of the body of a deceased insured scholar to their place of residence in their home country. This benefit does not include transportation expenses for any person accompanying the body. Prior approval from the Office of Risk Management is required.

Continuation Benefits
Benefits will be payable up to a maximum of benefit of $5,000 or 13 weeks, which ever comes first, for a covered injury or illness for which the insured scholar has a continuing claim on the date the individual's insurance terminates.

Mental and Nervous Disorders
Benefits will be paid for inpatient treatment of a mental or nervous disorder up to a limit of (a) 50% of covered inpatient hospital expenses or (b) a lifetime maximum of $5,000. Outpatient treatment will be paid at 50% of covered expenses subject to a lifetime maximum benefit of $300.

EXCLUSIONS
The Plan will not cover charges or expenses:
1. For medical care, treatment, supplies or services not listed in the types of Covered Expenses (A) through (H) or identified in the Plan as an additional benefit;
2. For medical care, treatment, supplies or services for the Insured Scholar in his/her home country or country of regular domicile
3. For elective or preventative surgery or medical care, services, supplies or treatments including, but in no way limited to, tubal ligation, vasectomy, breast reduction or enlargement, correction of treatment of a deviated septum, abortion (except spontaneous or non-elective abortion), learning disabilities, obesity, allergy tests, vitamins and antitoxins;
4. For routine physical or health examinations;
5. For any care in connection with the teeth, gums, jaw or structures directly supporting the teeth, myofacial pain, or tempomandibular joint disfunction, except the Plan will cover injury to natural teeth resulting from accidental injury occurring while insured up to a maximum benefit of $100 per tooth and an overall maximum benefit of $500 per injury;
6. In excess of the usual, customary and reasonable charge;
7. For cosmetic, plastic or reconstructive or restorative surgery unless such covered expenses are incurred for repair of a disfigurement caused from either: (a) an accidental injury sustained while the insured Scholar was insured under the Plan; or (b) a birth defect of an insured under the Plan;
8. For medical treatment, services, supplies or prescription drugs which are not medically necessary, as defined in the Plan;
9. For hearing aids, eyeglasses or contact lenses and the fitting or services thereof, except for expenses for same resulting from s covered injury for eye surgery or treatment to improve or correct vision.
10. For injury or illness if covered to any extent under: any occupational benefit plan; workers' compensation or similar law; a plan or program operated by a government or one of its agencies; public assistance programs; automobile medical payments or no-fault insurance; blanket insurance; or any other valed benefits plan on a group basis;
11. For birth control, including surgical procedures and devices;
12. For injury arising out of practice or participation in professional sports;
13. For medical care, treatment, services and supplies for which no charge is made or for which no payment would be required if the insured scholar did not have this insurance; or to the extent the insured scholar received any discount, credit or reduction due to an agreement with the provider;
14. For injury or illness arising directly or indirectly, wholly or partially, out of the use of alcohol, narcotics, hallucinogens, barbituates, marijuana, amphetamines, or similar drugs or substances, including but not limited to treatment of alcohol or drug dependency or both;
15. For diagnosis, treatment and all other care related to infertility;
16. For injury arising out of aeronautics such as hang gliding, skydiving, parachuting or air travel, except while riding as a passenger on a regularly schedule commercial airline;
17. Resulting from mental or nervous disorder, except that benefits will be paid in the manner and up to limits above under the heading "Mental and Nervous Disorders";
18. Resulting from a motor vehicle accident if an insured was operating the vehicle without a valid driver's license in the state where the insured primarily resides while at Northwestern University
19. For injury or illness resulting from an act of war (declared or undeclared), insurrection, terrorism, participation in the military service of any country or participation in a riot or civil disorder;
20. For medical care, treatment, service or supplies normally given without charge and provided by employees or physicians employed by, under contract with or retained by Northwestern University;
21. For medical care, treatment, services or supplies for which benefits are excluded, excepted or limited elsewhere in this Plan; and
22. For medical care, treatment, services or supplies for an injury or illness where such charge or expense is incurred more than 52 weeks after the date of the accident causing the injury or manifestation of the illness.

DEFINITIONS
"Average Semiprivate Charge" means (1) the standard charge by the hospital for semiprivate room and board accommodations or the average of such charges where the hospital has more that one established level of such charges, or (2) 80% of the lowest charge for by the hospital for single bed room and board accommodations where the hospital does not provide semi-private accommodations.
"Each Injury" means all injuries sustained in one accident including all related conditions and recurrent symptoms of these injuries.
"Each Illness" means illness causing one or more periods of hospital confinement and/or medical treatment resulting from the same or related causes.
"Hospital" means only such a place which operates as a hospital pursuant to law for the care and treatment of sick or injured individuals; has permanent and full-time care for bed patients; has a staff of one or more licenses physicians available at all times; provides 24-hour a day care by registered nurses on duty or call; has surgical facilities; and is not primarily engaged in business as a nursing home, home for the aged, or any similar establishment or any separate wing, ward or section of a hospital used as such.
"Hospital Admission" means a single period of hospital confinement or outpatient care for one or more causes.
"Injury" means an accidental bodily injury sustained by an insured which results directly from an accident which occurs while such individual is insured under the Plan and which occurs independent of any and all other causes.
"Illness" means a bodily infirmity of an insured which is the sole cause of loss and first manifests itself while the insured is covered under the Plan.
"Medically Necessary" means only care and treatment the University determines meets all of the following conditions: (1) the care and treatment is appropriate given the symptoms and is consistent with the diagnosis, if any. "Appropriate" means that the type, level and length of service and setting are needed to provide safe and adequate care and treatment; (2) it is rendered in accordance with generally accepted medical practice and professionally recognized standards; (3) it is not treatment that is generally regarded as experimental or unproven; and (4) it is specifically allowed by the licensing statutes that apply to the provider who renders the service.
"Mental or Nervous Disorder" means neurosis, psychoneurosis, psychosis or mental disease or disorder of any kind resulting from any cause including, but in no way limited to, biological cause.
"Physician" means a legally licensed practitioner of the healing arts acting within the scope of his/her license and who is not an insured scholar, a close relative of the insured scholar or residing in the same legal residence as the insured scholar.

CLAIMS PROCEDURE
Written notice of any event which may lead to a claim under the Plan must be provided to the Office of Risk Management within 60 days after the event.
Written proof of loss must be furnished to the Office of Risk Management within 90 days after the date of loss. Proper positive written notice and proof of loss must be given before the University will be liable for any loss.

IMPORTANT NOTICE
This brochure is a summary of the master insurance policy issued by Northwestern University. For the sake of brevity and convenience, certain policy language has been omitted or summarized. In the event of a discrepancy between this brochure and the master policy, the master policy language will govern.

Any provision of the Plan which, on its effective date, is in conflict with the laws of the governing jurisdiction, is herby amended to conform to the minimum requirement of those laws.

Northwestern University requires its visiting scholars to carry medical insurance coverage. This Plan must be accepted by the visiting scholar unless proof of other coverage, acceptable to the Office of Risk Management, is provided.

For information and assistance, contact the Northwestern University Office of Risk Management at (847) 491-5610.

Key Contacts:
Student Health Insurance Office: Ethlyn Senecal, (847) 491-4134
Office of Risk Management: Farah Swaim, (847) 491-5610
Evanston Campus Student Health Service: (847) 491-2119, 24-Hour Hotline: (847) 491-8100
Chicago Campus Student Health Service: (312) 908-8134, 24-Hour Call Back Line: (312) 915-8161
Omega: Glenview Office (847) 657-1700