COVERAGE

Medical Benefit Plan

Coverage is in effect 24 hours a day. For students enrolled during the Fall Semester, coverage will be in effect from either August 15, 2007 or the date of Premium Payment, whichever is later, until August 15, 2008. For students enrolled during the Spring Semester, coverage will be in effect from either January 15, 2008, or the date of Premium Payment, whichever is later, until August 15, 2008. The plan covers Injuries sustained and Sickness contracted and causing loss commencing during the coverage period. The Policy expires August 15, 2008. (Please note that the Policy cannot establish physician’s fees, and therefore, cannot guarantee that payments made by Monumental Life Insurance Company, hereafter referred to as the Company, will cover all physician and surgeon charges in full.)

Injury Medical Expense Benefits

Benefits are provided up to $3,000 for each injury for which medical treatment by a physician, surgeon, dentist, registered nurse, hospital services, ambulance services, or x-rays are rendered. The initial treatment must be rendered within 90 days of the Injury and benefits are limited to treatment rendered within 52 weeks of the date of Injury. There is a $50 deductible per Injury which is waived for treatment rendered at the Student Health Service. The deductible is also waived for treatment which is referred by the Student Health Service. The Student Health Service will be closed from June 30, 2007 until July 31, 2007. Deductibles are not waived during this period of time. Specific benefit levels are as shown below:

Hospital Room and Board: The expense actually incurred is
allowed not to exceed the semi-private rate per day.

Hospital Inpatient Miscellaneous Expense: The expenses actually incurred are allowed not to exceed $3,000 as the result of any one Injury.

Surgical Expense: The expense actually incurred is allowed not
to exceed the Usual and Customary Charge, or $3,000 in total for all surgical operation(s) performed for any one Injury.

Ambulance Expense: The expense actually incurred is allowed not to exceed $3,000 for any one Injury.

Physician’s Expense: The Usual and Customary Charge is allowed not to exceed $3,000 for any one Injury.

Registered Graduate Nurse Expense: The expense actually
incurred is allowed subject to a maximum benefit of the Usual and
Customary Charge per 24-hour period.

Outpatient Miscellaneous Expense: The expense actually incurred is allowed subject to a maximum $3,000 as the result of any one Injury.

Dental Expense: The Company will pay up to the Usual and Customary Charge per tooth with a maximum of $3,000 per Injury for treatment to sound and natural teeth injured in a covered accident.

Physiotherapy Benefit: Up to the Usual and Customary Charge per visit is allowed subject to a maximum of $3,000 for any one Injury.

Prescription Drug Expense: The expense actually incurred is allowed up to a maximum of $3,000 per covered Injury.

Anesthesia Expense: The expense actually incurred is allowed up
to 30% of the surgeon’s allowance under the Policy subject to a maximum of $500 for any one Injury.

Consultant’s Expense: The expense actually incurred is allowed up to $3,000 per covered Injury.

Accidental Death

$1,000 payable when Injury results in the loss of life.

Accidental Dismemberment

$1,000 payable per the schedule as shown in the Master Policy.

Sickness Medical Expense Benefits

Sickness benefits will be paid up to $3,000 for each sickness for medical expenses incurred within 52 weeks of the date of the first medical treatment. There is a $50 deductible per sickness which is waived for treatment received at the Student Health Service. The deductible is also waived for treatment referred by the Student Health Service. The Student Health Service will be closed from June 30, 2008 until July 31, 2008. Deductibles are not waived during this period of time. Specific benefit levels are as shown below:

Hospital Room and Board: The expense actually incurred is allowed not to exceed the semi-private rate per day.

Hospital Inpatient Miscellaneous Expense: The expenses
actually incurred are allowed not to exceed $3,000 as the result of
any one Sickness.

Surgical Expense: The expense actually incurred is allowed not
to exceed the Usual and Customary Charge, or $3,000 in total for all surgical operation(s) performed for any one Sickness.

Ambulance Expense: The expense actually incurred is allowed not to exceed $3,000 for any one Sickness.

Physician’s Expense: The expense actually incurred is allowed not to exceed $3,000 for any one Sickness.

Registered Graduate Nurse Expense: The expense actually incurred is allowed subject to a maximum benefit of the Usual and Customary Charge per 24-hour period or $3,000 as the result of
any one Sickness.

Outpatient Miscellaneous Expense: The expense actually incurred is allowed subject to a maximum $3,000 as the result of any one Sickness.

Prescription Drug Expense: The expense actually incurred is allowed up to a maximum of $3,000 per covered Sickness.

Anesthesia Expense: The expense actually incurred is allowed up to 30% of the surgeon’s allowance under the policy subject to a maximum of $3,000 for any one Sickness.

Consultant’s Expense: The expense actually incurred is allowed
up to $3,000 per covered Sickness.

Mental or Nervous Disorders Benefit: The Company will pay for
services rendered by a psychiatric consultant (in or out of the hospital) when an Insured is referred for counseling. The Company will pay $25.00 a visit up to a maximum of $250 worth of visits.

Mandated Benefits

The plan will pay for the following mandated benefits and any other applicable mandate in accordance with Pennsylvania insurance laws: Maternity Length of Stay, Mammography Benefits, Women’s Preventive Health Service Benefit including Gynecological Exam and Routine Pap Smear, Childhood Immunizations Benefit, Alcoholism and Drug Treatment Benefit, Mastectomy Reconstruction and Mastectomy Minimum Stays, Chemotherapy, Diabetes Supplies and Equipment, Emergency Services, Midwife, Serious Mental Illness, Newborn Length of Stay, and Metabolic Disease Formula.

REPATRIATION (For International Students Only)
In the event of the death of a covered International Student, the
Company will pay for those expenses as may reasonably be incurred up to the Maximum Limit of $10,000 in connection with the preparation and transportation of the body to the person’s place of residence in his home country. This benefit does not include the transportation expense of anyone accompanying the body.

MEDICAL EVACUATION (For International Students Only)
The Company will pay, as a result of a covered Injury or Sickness, and upon the written certification of the attending Physician, for air evacuation of the covered International Student, including Physician or nurse accompaniment, the actual expense incurred, but not to exceed $10,000 in the aggregate. Evacuation may be to his/her natural country or to a hospital operated pursuant to the law for the care and treatment of injured or ill persons. Any expenses in respect to Medical Evacuation requires prior approval of the Company. Call Bollinger Inc. 1-866-267-0092. Medical Evacuation to home country, will terminate any further coverage under the Policy.

Major Medical Expenses

For Both Injury and Sickness

After the Company pays $3,000 in Basic Benefits under either the Injury or Sickness provision of the policy for any one accident or Sickness, the Policy will pay 80% of the expenses incurred in excess of $3,000 up to but not exceeding $12,000 for Domestic students and $22,000 for International students for physician’s services, hospital confinement, nursing services, X-Rays, operating room, emergency room, anesthesia, laboratory service, dressings, prescription medicines, casts, use of wheel chair, crutches, or ambulance for any one covered Injury or Sickness. Expenses must be incurred within two years from the date of Injury or date of the first treatment in the event of Sickness.

Exclusions

The Policy does not cover:

1. Service or treatment rendered as part of the duties of a physician or any other person employed or retained by the Policyholder;

2. Injury sustained or caused by any act of war, riots, civil disorders, or commotions;

3. Eyeglasses, contact lenses, or prescriptions therefor;

4. Congenital defect;

5. Injuries sustained as a result of practice or participating in intercollegiate sports in any form;

6. Injury or Sickness for which the Insured is entitled to benefits under any Worker’s Compensation Act or Law or similar legislation, or medical expenses covered under any Automobile Reparations Reform Act, or Automobile No-Fault Law, or similar legislation;

7. Any loss sustained or contracted in consequence of the Insureds being intoxicated or under the influence of any narcotic unless administered on the advice of a physician;

8. Air travel except as a fare-paying passenger on a commercial aircraft;

9. Expense incurred as a result of mental disorders of any type but only as it pertains to Major Medical Benefits;

10. Health treatment or examinations where no Injury or Sickness is involved;

11. Elective abortions or any other voluntary termination of pregnancy;

12. Dental treatment except for Injury to sound, natural teeth;

13. Treatment in any Veterans Administration or Federal Hospital, except if there is a legal obligation to pay;

14. Elective surgery, or Elective Treatment;

15. Services or treatment rendered by a Physician or nurse who is the Insured or a member of his immediate family;

16. Preventative medicines, serums, or vaccines;

17. An Insured’s commission of or attempt to commit a felony or to which a contributing cause was the Insured’s being engaged in an illegal occupation.

Claim Procedure

In the event of Injury or Sickness, the student should:

1. If at college, in a non-emergency situation, report at once to the Health Center;

2. If away from college, secure treatment at the nearest hospital or physician, pay the bill, and obtain a copy of the bill. The Health Center will instruct you in filing for benefits.

Proofs of loss must be submitted within 90 days following the date of Injury or start of Sickness.
Claim forms are available at this web site, or from the Health Center.

Travel Assistance Program (Provided by On Call International) Each Insured Student and his/her enrolled Dependents are eligible for travel assistance services when traveling 100 miles or more away from their home and campus address. Travel Services are only available for medical claims that are covered under the Student Injury and Sickness Insurance Plan. Services provided include: Medical Consultation & Evaluation Critical Care Monitoring Emergency Message Transmission Hospital Admission Guarantee Prescription Medication Dispatching Family/Friend Transportation Within North America Call 1-800-407-7307 Outside North America Call 1-603-898-9159 Note: The Travel Assistance program in not insurance. It is connected with or provided by Monumental Life Insurance Company. On Call International Benefits are available 24 hours a day, 7 days a weeks, 365 days a year.

PLAN ADMINISTERED BY:

Notification of Injury or Sickness bust be provided to:

101 JFK PARKWAY
SHORT HILLS, NJ 07078
(866) 267-0092 (Claims/Coverage)
(800) 526-1379 (Other Questions)
 <

PLEASE PRINT OUT THIS BROCHURE AND KEEP IT AS A GENERAL SUMMARY OF THE INSURANCE BENEFITS. The Master Policy on file at the College contains all of the provisions, limitations, exclusions and qualifications of your insurance benefits, some of which may not be included on this brochure. If any discrepancy exists between the brochure and the Master Policy, the Master Policy will govern and control the payment of benefits.

Policy Form SH3000GPM.PA (Rev. 12/04

999333