| COVERAGES: | LIMITS (PER SURROGATE): |
Surrogacy Contractual Expense Liability Policy
Policy Limit: | $500,000 (any one pregnancy and in the aggregate) |
Surrogacy Contractual Expense Liability Policy
In-Patient Bed Rest (sub-limit): | $50,000 (any one pregnancy; pre-authorization required) |
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| PROVISIONAL SELF INSURED RETENTION: | AMOUNTS: |
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| Single Child - Vaginal Delivery: | Beginning at $19,000 (any one Surrogate; any one pregnancy) |
| Single Child - C-Section Delivery: | Beginning at $24,000 (any one Surrogate; any one pregnancy) |
| Twins: | Beginning at $31,500 (any one Surrogate; any one pregnancy) |
| Triplets or Greater: | Case Management Program |
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| PLAN PERIOD: | Up To 20 Months (including cycle period) |
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PREMIUM:
(Surrogacy Contractual Expense Liability Policy) | Beginning at $8,200 plus taxes, if applicable (any one pregnancy) |
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ENROLLMENT FEE:
(Case Management Program) | Beginning at $1,700 (per Surrogate) |
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COVERAGE CRITERIA:
(including but not limited to) |
- Age between 21 and 38 (individual applicants greater in age may be eligible at policy terms to be agreed).
- Satisfactory Completed Application Form (inlcuding Physician Medical Authorization)
- Gestational Surrogate has no adverse medical conditions and/or known or existing and/or prior medical conditions that may be cause for concern of any medical complications related to the maternity and childbirth.
- Medical Services to be provided in the United States.
- Beitler Services pre-certification of Surrogate's maternity, pregnancy and childbirth related medical services.
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| CASE MANAGEMENT PROGRAM: | - Surrogate
If Surrogate does not meet the requirements of meeting a qualified Surrogate under Beitler Services Surrogate program. Surrogate can still qualify under the Case Management Program.
- New Born
Medical management services can be provided for complications for new borns under the Case Management Program.
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| INSURER: | Lloyd's of London (A.M. Best's "A" Rated, Excellent) |
