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STUDENT ACCIDENT & SICKNESS INSURANCE PLAN

2019 Summer Program

This policy is required for any student who is only coming for the summer and not attending the academic year.

Out of concern for the health and welfare of our students, Perkiomen School has established a policy that requires every student enrolled to be covered by a comprehensive accident and sickness insurance plan. The cost of medical services in the United States is high and often students arrive on campus without insurance or without coverage that is acceptable to local hospitals, clinics or other practitioners.

To help you meet this financial responsibility, we offer the PREMIER HEALTH PLAN which provides primary insurance for those of you who do not have coverage at all or for those of you whose present insurance does not protect your child outside of your geographical area. This policy will cover students from the duration of their program period anywhere in the world from July 22, 2019 to August 18, 2019. The total cost is $230. This plan was designed especially for private secondary schools and meets the mandated requirements of Pennsylvania state law.

Any domestic students and international students who do not have coverage with a USA based company (as a dependent on their parents plan) must enroll in this plan.Many USA parents, who are insured in some type of HMO, PPO, or in any form of a managed care network program, should consider this plan. In severe cases, your child may have no coverage when stepping outside your “network.” In all cases your up-front deductibles and co-payments will increase substantially, so much that you may want to have primary first dollar benefits under this plan.

All parents must complete the form below to elect coverage or give evidence of existing coverage.If we do not hear from youprior to the start of the program your child will be automatically enrolled in the school plan and the $230 premium will be charged on your child’s account for the duration of the program.

Please check the appropriate box, include the student's name, sign your name, date and submit this form promptly. Be sure to enter the name of your present insurance company.​​​​​​​​​

Student Information

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