FAQs

General FAQs

Our comprehensive travel medical and trip cancellation insurance programs protect international travelers from the high costs and inconveniences of hospitalizations, surgeries, doctors visits, prescriptions, medical evacuations, political evacuations, trip cancellations or disruptions, airline bankruptcies, lost luggage and return of remains.

Don’t assume your health insurance, home owner’s insurance, Medicare, Medicaid or credit card policies will cover you when you travel internationally – in many cases, they do NOT. Seven Corners offers comprehensive travel medical and trip cancellation insurance policies to protect you and your family when you travel overseas.

Seven Corners is an industry leader in travel medical and trip cancellation insurance policies. We offer a variety of programs, outstanding customer service, understandable and affordable policies, a network of thousands of international doctors and hospitals, and 24/7 emergency assistance to travelers.

Yes, considering 3 out of every 100 vacationers experience some type of unexpected, expensive illness, medical emergency or accident when they travel. Most people do not realize how important medical coverage is while they travel abroad. Keep in mind, your standard health insurance may not cover you when you leave your home country.

IMPORTANT:
In the US, when you call a doctor’s office for an appointment or present your ID card to a provider, it is important for you to say: “My healthcare coverage utilizes the ChoiceCare PPO Network. Are you a ChoiceCare provider?” (NOTE: Unless you are in New York or New Jersey, please say “PHCS” instead of ChoiceCare)

DO NOT SAY:
“I have Seven Corners’ Insurance” or “I use Seven Corners’ Network” or “I have Liaison International insurance.” Providers WILL NOT recognize this language and your coverage might not be accepted.

Travel Assistance

A: Seven Corners’ Assist Department is available to answer questions regarding our International Provider Network. Once a customized network has been set up, members also can access the customized provider directory specifically designed for that network via a web portal.

A: Seven Corners gives its members ID cards that provide the necessary information for filing a claim outside of the U.S.

A: Seven Corners’ contracted providers submit bills directly to Seven Corners, and Seven Corners submits payment to the provider for the portion of the service that is a covered benefit and the responsibility of the carrier. Members are responsible for payment of non-covered services, co-pays, deductibles, etc. If this is managed through a Seven Corners travel medical insurance policy, the payment to the provider comes from Seven Corners’ funding rather than the U.S. carrier, health plan or employer.

If a provider does not have an existing contract with Seven Corners, we will attempt to work directly with the provider for guarantee of payment if we are notified prior to the scheduled visit. If a member is required to make full payment at the time the medical services are rendered, Seven Corners will reimburse the member for covered benefits that are the responsibility of the funding organization (carrier, health plan, employer or Seven Corners, if travel medical insurance is purchased through us). Members are responsible for payment for non-covered services, co-pays, deductibles, etc. Paying at the time of service will not affect the negotiated rate, if a negotiated rate has been established. Members must submit the appropriate form with a copy of their medical bills.

A: Seven Corners has an established network of thousands of international health care providers – and the network is always growing. We do not provide our clients with a detailed list of providers until a contract has been signed. However, we can provide numbers and specialties by city, and we often build networks based around specific location needs. We also provide references from clients for whom we have developed customized international provider networks.

A: Seven Corners has an internal assistance unit that coordinates evacuations and repatriations. Additionally, we are contracted with an outside assistance specialty company that works with us to obtain the most competitive air ambulance provider arrangement for each specific case.

A: Seven Corners utilizes its proprietary country profiles to determine provider quality standards as well as international accreditations.

A: Typically U.S. coverage does not cross international borders for traveling employees, employees who are living outside of the United States, or employees who are citizens of another country. Additionally, coverage does not provide for steerage to quality health care providers outside of the United States. Seven Corners solves this issue by allowing U.S. commercial carriers or employers to access our non-U.S. provider network, which consists of quality doctors and hospitals throughout the world.

A: Payment in foreign currency is required by most international health care providers. By paying our providers in their country’s currency, Seven Corners can ensure a quicker and more reliable claims process for you and your employees.

A: Seven Corners translates claims and converts to U.S. coding standards for reporting purposes.

Claim FAQs

Follow the steps below:
  • Complete and sign the Proof of Loss Form.
  • Submit the following documents with your completed Proof of Loss Form.
    • Copies of your Passport including the identification page and the entry/exit stamps from the past 12 months.
    • Detailed bills for services received.
    • Receipts for payments made.
    • Any other supporting medical documentation provided.

Substitution of a different payee (not the insured) on a claim reimbursement can be accomplished, but authorization from the insured is needed.

 

A written document must be provided and signed by the insured, authorizing Seven Corners to reimburse the other party named in the document. This document is required to protect all parties from possible incorrect payment of funds. An address must be listed in the document stating where claims payments should be sent. Please keep in mind that claims must be submitted within 90 days from the date of service.

Wire transfers are possible for claim payment (some restrictions may apply). In order to process such a request, detailed banking information is required. Please obtain contact information and forward to claims@sevencorners.com. Our claims personnel will contact you within two business days. Please keep in mind that claims must be submitted within 90 days from the date of service.

 

You may appeal the decision made on your claim by filing an appeal with us. Please visit our Appeals page for instructions on how to file an appeal. 

 

We will have your documents translated. If the claim is considered eligible, you will be reimbursed in U.S. dollars, based on the exchange rate for the U.S. dollar on your date of service. Please keep in mind that claims must be submitted within 90 days from the date of service.

 

Claims documents must be signed and submitted within 90 days from the date of service via postal mail, fax or email attachment to:

 

Affordable Care Act FAQs

The “Patient Protection and Affordable Care Act,” commonly known as PPACA, was first introduced as a measure to deal with rising healthcare costs and numbers of uninsured.

The heart of PPACA consists of three provisions: guaranteed issue (insurers must offer coverage regardless of the applicant’s health status or pre-existing conditions), community rating (insurers must offer policies within a given territory at the same price regardless of health status, age, gender, or other factors), and an individual mandate. The individual mandate assures that everyone has a minimum amount of coverage: those above a certain annual income are required to purchase coverage or incur a tax penalty; those who cannot afford it will have their coverage paid for by the government.

As PPACA continues to be implemented and challenged throughout the country, understanding the issues and implications for the international insurance industry and your business becomes all the more important.

We frequently receive questions about PPACA from producers and customers. Below are some frequently asked questions and answers to help you understand PPACA’s impact on the international insurance business.

U.S. citizens who live abroad for a calendar year (or at least 330 days within a 12 month period) are treated as having “minimum essential coverage” for the year (or period) and, therefore, are not required to purchase PPACA coverage. These are individuals who qualify for an exclusion from income under section 911 of the IRS Code. See the IRS foreign earned income exclusion test for further information on this exclusion. They need take no further action to comply with the individual mandate.

Please note that Seven Corners’ Critical Illness Insurance Plan does not meet the definition of “minimum essential coverage” under PPACA. The Reside® programs are not intended to provide U.S. citizens residing in the U.S. with health insurance. While your Reside®  plan for worldwide coverage will not be affected by PPACA, you should review the information below to see if you are exempt from the requirements of PPACA or not, and whether you will have to pay a tax penalty or not.

Under PPACA, all U.S. citizens, nationals and resident aliens will be required to purchase minimum essential coverage (PPACA compliant coverage), unless they are exempt. Exempt U.S. citizens include U.S. citizens who reside outside of the U.S. The exemption applies to:

  • A U.S. citizen who has a tax home (your main place of work or employment, or if you don’t have a main place of work or employment, your main residence) in a foreign country, and
    • has been a bona fide resident of a foreign country or countries for an uninterrupted period that includes an entire taxable year; or
    • is present in a foreign country or countries during at least 330 full days in a twelve month period.

See details under the IRS foreign earned income exclusion test.

Tax Calculations:

Taxes begin in 2014 and rise in years following. In each year, the tax consists of the higher of a dollar amount or a percentage of household income. For a given household, the tax applies to each individual, up to a maximum of three. Following is the schedule of taxes:

  • 2014: The higher of $95 per person (up to 3 people, or $285) OR 1.0% of taxable income.
  • 2015: The higher of $325 per person (up to 3 people, or $975) OR 2.0% of taxable income.
  • 2016: The higher of $695 per person (up to 3 people, or $2,085) OR 2.5% of taxable income.
  • After 2016: The same as 2016, but adjusted annually for cost-of-living increases.

Tax Examples

2014 – family of 2; taxable income = $26,000;
tax = $260 because $260 ($26,000 x 1%) is higher than $190 ($95 x 2 persons).

2014 – family of 3; taxable income = $26,000;
tax = $285 because $285 ($95 x 3 persons) is higher than $260 ($26,000 x 1%).

Under PPACA, all U.S. citizens, nationals and resident aliens will be required to purchase minimum essential coverage (PPACA compliant coverage), unless they are exempt.

Seven Corners’ Critical Illness Insurance Plan does not meet the definition of “minimum essential coverage” under PPACA. While your Reside®  plan for worldwide coverage will not be affected by PPACA, you should review the information below to see if you are exempt from the requirements of PPACA or not, and whether you will have to pay a tax penalty or not.

The IRS provides a questions and answers page on the individual mandate. Question 11 asks whether all individuals living in the U.S. are subject to the mandate. The answer is that U.S. citizens and permanent legal residents are subject to the mandate, as are “foreign nationals who are in the U.S. long enough during a calendar year to qualify as resident aliens for tax purposes.” Thus, non-resident aliens are not subject to the individual mandate, even if they have to file a tax return.

The IRS states that you are a non-resident alien unless you meet either the green card test or the substantial presence test.

According to IRS Publication 519, Tax Guide for Aliens, under the green card test, green card holders are resident aliens for tax purposes. The substantial presence test uses a formula to count the number of days present in the U.S. over the past 3 years. Generally, you are a resident alien after six months of presence in the U.S. – unless you are exempt.

Exempt non-U.S. citizens include:

  • A non-U.S. citizen who is not a permanent legal resident (the green card test) or has not been in the U.S. for 183 days over the last three year period.
  • A non-U.S. citizen temporarily present in the United States as a foreign government-related individual under an “A” or “G” visa.
  • A non-U.S. citizen teacher or trainee temporarily present in the United States under a “J” or “Q” visa.
  • A non-U.S. citizen student temporarily present in the United States under an “F,” “J,” “M,” or “Q” visa.
  • A non-U.S. citizen professional athlete temporarily in the United States to compete in a charitable sports event; and
  • Expatriate employees living outside of their home countries for six months or more of a year.
  • A person who is required to, but does not have minimum essential coverage for up to three months during the year (only one three-month period allowed each year).

Here are some Alien Residence examples to assist you.

Seven Corners’ short-term international travel medical products are not a substitute for minimum essential coverage that you may need to have under PPACA. If you are a U.S. citizen, national or legal resident alien in the U.S., you will need to maintain minimum essential coverage unless you are exempt. Exemptions include:

  • Individuals not residing in the U.S.
  • Non-U.S. citizens who are “non-resident aliens” (for U.S. income tax purposes).  See Am I a Resident or Non-Resident Alien?
  • Individuals with a coverage gap of less than 3 months
  • Individuals who cannot afford coverage (i.e. required contribution exceeds 8% of household income)
  • Individuals with a religious conscience exemption (applies only to certain faiths)
  • Members of a health care sharing ministry
  • Incarcerated individuals
  • Individuals with income below the tax filing threshold; and
  • Members of Indian tribes.

You will not need PPACA coverage for short-term travel to the U.S., unless you are considered an “alien lawfully present” in the U.S. See I am a Non-U.S. citizen covered under a Reside®  Plan.

In general, PPACA does not govern short-term limited duration insurance.

However please understand that under PPACA, as of January 1, 2014, extensions of short-term coverage will be limited to less than 12 months to meet the definition of a short-term limited duration plan.

Seven Corners’ short-term international travel medical products are not a substitute for minimum essential coverage that you may need to have under PPACA. However, since most PPACA plans do not provide the types of international benefits and assistance that travelers need, you should strongly consider purchasing an international travel medical plan such as Seven Corners’ Travel Medical Insurance for coverage while you travel outside of the U.S.

If you are a U.S. citizen, national or an “alien lawfully present” in the U.S., you will need to maintain minimum essential coverage unless you are exempt. Exemptions include:

  • Individuals not residing in the U.S.
  • Non-U.S. citizens who are “non-resident aliens” (for U.S. income tax purposes). See Am I a Resident or Non-Resident Alien?
  • Individuals with a coverage gap of less than 3 months.
  • Individuals who cannot afford coverage (i.e. required contribution exceeds 8% of household income).
  • Individuals with a religious conscience exemption (applies only to certain faiths).
  • Members of a health care sharing ministry.
  • Incarcerated individuals.
  • Individuals with income below the tax filing threshold; and
  • Members of Indian tribes.

In general, PPACA does not govern short-term limited duration insurance, like Seven Corners’ short-term travel medical insurance programs (Liaison International, Liaison Continent, and Liaison Majestic).

However, please understand that under PPACA, as of January 1, 2014, extensions of short-term coverage will be limited to less than 12 months to meet the definition of a short-term limited duration plan.

On March 8, 2013, the Departments of Labor, Health and Human Services and Treasury issued a Frequently Asked Question (FAQ) announcing that, for expatriate plans, compliance with most PPACA provisions is being delayed until January 1, 2016. The relief from compliance applies for plan years 2014 and 2015 on plans that meet the following definition:

“Insured group health plans with plan years ending on or before December 31, 2015, in which enrollment is limited to individuals residing outside of their home country for at least six months of the plan year and any covered dependents.”

As non-resident aliens, international students on F, J, M and Q visas (and certain family members of students) are not subject to the individual mandate for their first 5 years in the U.S. All other J categories (teacher, trainee, work and travel, au pair, high school, etc.) are not subject to the individual mandate for 2 years (out of the past six).

Since international students are not subject to the mandate, they are not required to purchase a plan that meets PPACA requirements and can purchase an appropriate Seven Corners’ plan.

International Students – Exempt as Non-Resident Aliens

Under the IRS international student exemption, anyone “temporarily in the United States on an “F”, “J”, “M”, or “Q” visa for the primary purpose of studying at an accredited academic institution or vocational school (and certain family members of students), and who substantially complies with the requirements of that visa,” is exempt from being treated as a resident alien, and is therefore exempt from the individual mandate as a non-resident alien.

That exemption applies for 5 years. After 5 years, a student is no longer exempt, and the substantial presence test must be applied. See examples at http://www.irs.gov/Individuals/International-Taxpayers/Alien-Residency-Examples.

Even after 5 years in the U.S., an international student may continue to be a non-resident alien for tax purposes under the “Closer Connection” exception if they can prove that they still have a closer connection to their home country than to the U.S.

The Individual Mandate and Alien / Non-Alien Status

The IRS provides a questions and answers page on the individual mandate. Question 11 asks whether all individuals living in the U.S. are subject to the mandate. The answer is that U.S. citizens and permanent legal residents are subject to the mandate, as are “foreign nationals who are in the U.S. long enough during a calendar year to qualify as resident aliens for tax purposes.” Thus, non-resident aliens are not subject to the individual mandate, even if they have to file a tax return.

The IRS states that you are a non-resident alien unless you meet either the green card test or the substantial presence test.

Under IRS Publication 519, Tax Guide for Aliens (the green card test), green card holders are resident aliens for tax purposes. The substantial presence test uses a formula to count the number of days present in the U.S. over the past 3 years. Generally, you a resident alien after six months of presence in the U.S. – unless you are exempt.

No. Under PPACA, the term “health insurance coverage” means insurance benefits offered by a “health insurance issuer,” which is an insurance company that is licensed to engage in the business of insurance in a State of the U.S. and which is subject to State law that regulates insurance. Seven Corners’ international plans are underwritten by Certain Underwriters at Lloyd’s, London, Tramont Insurance Company Limited, Nationwide, and United States Fire Insurance Company  for persons that are not eligible for or required to purchase a PPACA plan. If you are now eligible for or required to purchase a PPACA plan and the PPACA plan application asks you whether you currently have “health insurance coverage,” you should answer that question “No.”

Documents

Privacy Information
Terms of Use
Security Statement

Connect with Seven Corners

About Us
Careers

   

Contact Us