Seguro Internacional | Full
Sapphire
From
US$ 326 . 01
FIRST’ EXPAT//RELAIS’ EXPAT
// INFORMATION BOOKLET SERVING AS THE GENERAL TERMS & CONDITIONS
// INFORMATION BOOKLET SERVING AS THE GENERAL TERMS & CONDITIONS
3
1. / PRESENTATION OF ASFE, ITS ADMINISTRATOR MSH INTERNATIONAL
AND PURPOSE OF THE INSURANCE
1.1. / PRESENTATION OF ASFE AND ITS ADMINISTRATOR (MSH INTERNATIONAL)
You have chosen an ASFE (Association of Services for Expatriates) international health insurance plan from Groupama Gan Vie,
managed by MSH International, and we are delighted to welcome you as a member.
ASFE, the Association of Services For Expatriates, was created in 1992 and is governed by the French law of 1901 on associations.
Its purpose is to provide expatriates all over the world with solutions in the fields of healthcare coverage, life & disability, medical
assistance / repatriation and third-party liability. Throughout this document ASFE will be referred to as “ASFE” or the “Contracting
association”.
MSH International, the designer and Administrator of ASFE plans, is a world leader in international benefits with over 400,000 globally-
mobile individuals insured worldwide. MSH International provides you with the services of a dedicated team which is on hand to
support and advise you day after day. MSH International, an organization mandated by the Insurer to administer the plan will be
referred to throughout this document as “MSH International”, “the Administrator”, “the Administrating Organization” whenever this
term is used in the context of the administrative management of the plan.
The plan is insured by Groupama Gan Vie – a French “société anonyme” with a capital of 1,371,100,605 euros (fully paid) - registered
with the Paris Trade and Companies Register under number 340 427 616 - APE 6511 Z Head office: 8-10 rue d’Astorg - 75383 PARIS
Cedex 08, France - Company regulated by the French Insurance Code and subject to the French Prudential Supervision and Resolution
Authority (ACPR) – 4 place de Budapest - CS 92459 - 75436 Paris Cedex 09, France, hereinafter referred to as “the Insurer”.
1.2. / PURPOSE OF THE INSURANCE
The ASFE Insurance plans in which you are enrolled are a type of plan known as “open group”. They provide coverage from the 1st
euro/1st dollar or in addition to benefits provided by the CFE (Caisse des Français de l’Etranger), to the exclusion of any other
healthcare insurance scheme.
Their purpose, within the limit of actual costs, is the payment of Benefits, from the 1st euro/1st dollar or in addition to benefits paid
by the CFE, as a reimbursement of medical expenses incurred by ASFE Members living outside their Home country, in a private or
professional capacity as well as any Dependents as defined below, whether or not they are residing in the same foreign country, if
they are enrolled in the plan.
Your membership of these plans will be referred to throughout this document as “Your membership”. You and any dependents
enrolled in the plan will be referred to as “Insured member”.
Each plan provides basic healthcare coverage which can be supplemented by optional benefits and 4 levels of coverage within these
options, Quartz, Pearl, Sapphire, and Diamond (see section 1.3/ Coverage options p.3). Each plan also includes 5 coverage zones (see
section 1.4/ / Coverage zones under the plan p.4).
These plans are numbered as follows:
FIRST’ EXPAT (1st euro/1st dollar):
- No. 0210/863689/00010, No. 0210/863689/00020, No. 0210/863689/00030, No. 0210/863689/00040 and No. 0210/863689/55555;
- No. 0210/863691/00020, No.0210/863691/00030, No.0210/863691/00040 and No.0210/863691/55555;
RELAIS’ EXPAT (as a top-up to the CFE):
- No. 0210/863690/00010, No.0210/863690/00020, No. 0210/863690/00030, No. 0210/863690/00040 and No.0210/863690/55555;
- No. 0210/863692/00020, No.0210/863692/00030, No.0210/863692/00040 and No. 0210/863692/55555.
As part of your membership, your healthcare benefits are supplemented as standard by medical assistance benefits. Europ
Assistance, a company regulated by the French Insurance Code, insures and operates the Assistance Services.
The plans provide a very comprehensive and flexible offer tailored to individual needs. You can also purchase life & disability benefits
to protect you in the event of death or sick leave from work.
1.3. / COVERAGE OPTIONS
The plan provides:
a range of BASIC BENEFITS (commercialized as ‘HEALTH’) covering costs related to hospitalization, Routine healthcare on
an outpatient basis, Preventive and alternative medicine, pharmacy items, equipment and medical Prostheses,
two OPTIONAL BENEFITS available in addition to the BASIC BENEFITS (HEALTH), chosen by each Member, covering the
following costs:
LEVEL 1 OPTIONAL BENEFITS (commercialized as ‘HEALTH+’): Vision and Dental
LEVEL 2 OPTIONAL BENEFITS (commercialized as ‘HEALTH+CHILD’): Maternity.
1. / PRESENTATION OF ASFE, ITS ADMINISTRATOR MSH INTERNATIONAL
AND PURPOSE OF THE INSURANCE
1.1. / PRESENTATION OF ASFE AND ITS ADMINISTRATOR (MSH INTERNATIONAL)
You have chosen an ASFE (Association of Services for Expatriates) international health insurance plan from Groupama Gan Vie,
managed by MSH International, and we are delighted to welcome you as a member.
ASFE, the Association of Services For Expatriates, was created in 1992 and is governed by the French law of 1901 on associations.
Its purpose is to provide expatriates all over the world with solutions in the fields of healthcare coverage, life & disability, medical
assistance / repatriation and third-party liability. Throughout this document ASFE will be referred to as “ASFE” or the “Contracting
association”.
MSH International, the designer and Administrator of ASFE plans, is a world leader in international benefits with over 400,000 globally-
mobile individuals insured worldwide. MSH International provides you with the services of a dedicated team which is on hand to
support and advise you day after day. MSH International, an organization mandated by the Insurer to administer the plan will be
referred to throughout this document as “MSH International”, “the Administrator”, “the Administrating Organization” whenever this
term is used in the context of the administrative management of the plan.
The plan is insured by Groupama Gan Vie – a French “société anonyme” with a capital of 1,371,100,605 euros (fully paid) - registered
with the Paris Trade and Companies Register under number 340 427 616 - APE 6511 Z Head office: 8-10 rue d’Astorg - 75383 PARIS
Cedex 08, France - Company regulated by the French Insurance Code and subject to the French Prudential Supervision and Resolution
Authority (ACPR) – 4 place de Budapest - CS 92459 - 75436 Paris Cedex 09, France, hereinafter referred to as “the Insurer”.
1.2. / PURPOSE OF THE INSURANCE
The ASFE Insurance plans in which you are enrolled are a type of plan known as “open group”. They provide coverage from the 1st
euro/1st dollar or in addition to benefits provided by the CFE (Caisse des Français de l’Etranger), to the exclusion of any other
healthcare insurance scheme.
Their purpose, within the limit of actual costs, is the payment of Benefits, from the 1st euro/1st dollar or in addition to benefits paid
by the CFE, as a reimbursement of medical expenses incurred by ASFE Members living outside their Home country, in a private or
professional capacity as well as any Dependents as defined below, whether or not they are residing in the same foreign country, if
they are enrolled in the plan.
Your membership of these plans will be referred to throughout this document as “Your membership”. You and any dependents
enrolled in the plan will be referred to as “Insured member”.
Each plan provides basic healthcare coverage which can be supplemented by optional benefits and 4 levels of coverage within these
options, Quartz, Pearl, Sapphire, and Diamond (see section 1.3/ Coverage options p.3). Each plan also includes 5 coverage zones (see
section 1.4/ / Coverage zones under the plan p.4).
These plans are numbered as follows:
FIRST’ EXPAT (1st euro/1st dollar):
- No. 0210/863689/00010, No. 0210/863689/00020, No. 0210/863689/00030, No. 0210/863689/00040 and No. 0210/863689/55555;
- No. 0210/863691/00020, No.0210/863691/00030, No.0210/863691/00040 and No.0210/863691/55555;
RELAIS’ EXPAT (as a top-up to the CFE):
- No. 0210/863690/00010, No.0210/863690/00020, No. 0210/863690/00030, No. 0210/863690/00040 and No.0210/863690/55555;
- No. 0210/863692/00020, No.0210/863692/00030, No.0210/863692/00040 and No. 0210/863692/55555.
As part of your membership, your healthcare benefits are supplemented as standard by medical assistance benefits. Europ
Assistance, a company regulated by the French Insurance Code, insures and operates the Assistance Services.
The plans provide a very comprehensive and flexible offer tailored to individual needs. You can also purchase life & disability benefits
to protect you in the event of death or sick leave from work.
1.3. / COVERAGE OPTIONS
The plan provides:
a range of BASIC BENEFITS (commercialized as ‘HEALTH’) covering costs related to hospitalization, Routine healthcare on
an outpatient basis, Preventive and alternative medicine, pharmacy items, equipment and medical Prostheses,
two OPTIONAL BENEFITS available in addition to the BASIC BENEFITS (HEALTH), chosen by each Member, covering the
following costs:
LEVEL 1 OPTIONAL BENEFITS (commercialized as ‘HEALTH+’): Vision and Dental
LEVEL 2 OPTIONAL BENEFITS (commercialized as ‘HEALTH+CHILD’): Maternity.
4
Important: Level 2 optional benefits can only be selected if Level 1 optional benefits have themselves been selected.
Within each of these benefits, four packages are offered to each Member on enrollment: Quartz, Pearl, Sapphire and Diamond,
providing increasing levels of benefits and services.
The plan also offers, in respect of Basic benefits and Level 1 Optional benefits (excluding Level 2 optional Maternity benefits), the
possibility for the Member to choose a Deductible as defined in chapter 3/ p.11. Four levels of Deductible are available as well as the
option of having no Deductible.
For Zone 5 (USA), the plan also offers various levels of co-payment.
It is specified that:
the optional benefits, if they are selected by the Member, also apply to all of their Dependents listed on the Certificate of
enrollment,
a Member who has purchased optional benefits will only be able to withdraw from these optional benefits once for the
entire duration of the plan in order to retain only the basic benefits.
1.4. / COVERAGE ZONES UNDER THE PLAN
There are 5 different Coverage zones under the plan, defined as follows:
- Zone 5: USA and territories under US jurisdiction (Porto Rico, United States Virgin Islands, Northern Mariana Islands, United States
Minor Outlying Islands, American Samoa) as well as countries of Zones 1, 2, 3 and 4
- Zone 4: Bahamas, Brazil, China, Hong Kong, Jersey, St. Barthelemy, St. Martin, Singapore, Switzerland, United Kingdom and countries
in Zones 1, 2 and 3
- Zone 3: Australia, Austria, Canada, French Polynesia, Greece, Ireland, Israel, Italy, Japan, New Zealand, Portugal Qatar, Russia, Saint
Pierre and Miquelon, Spain, Taiwan, Turkey, United Arab Emirates, Vanuatu and countries in Zones 1 and 2
- Zone 2: Andorra, Angola, Argentina, Azerbaijan, Bahrain, Barbados, Belarus, Belgium, Bolivia, Bosnia and Herzegovina, Bulgaria,
Chile, Colombia, Costa Rica, Croatia, Cyprus, Czech Republic, Denmark, Djibouti, Dominican Republic, Ecuador, Finland, Georgia,
Germany, Guatemala, Hungary, Iceland, Kazakhstan, Kuwait, Latvia, Lebanon, Liechtenstein, Luxembourg, Malaysia, Mexico, Monaco,
Mozambique, Netherlands, Nigeria, Norway, Oman, Panama, Peru, Saudi Arabia, Slovakia, South Africa, Sweden, Thailand, Ukraine,
Uruguay, Venezuela, Vietnam, Wallis and Futuna and countries in Zone 1
- Zone 1: Worldwide (including France) excluding countries in Zones 2 to 5
Important: Level 2 optional benefits can only be selected if Level 1 optional benefits have themselves been selected.
Within each of these benefits, four packages are offered to each Member on enrollment: Quartz, Pearl, Sapphire and Diamond,
providing increasing levels of benefits and services.
The plan also offers, in respect of Basic benefits and Level 1 Optional benefits (excluding Level 2 optional Maternity benefits), the
possibility for the Member to choose a Deductible as defined in chapter 3/ p.11. Four levels of Deductible are available as well as the
option of having no Deductible.
For Zone 5 (USA), the plan also offers various levels of co-payment.
It is specified that:
the optional benefits, if they are selected by the Member, also apply to all of their Dependents listed on the Certificate of
enrollment,
a Member who has purchased optional benefits will only be able to withdraw from these optional benefits once for the
entire duration of the plan in order to retain only the basic benefits.
1.4. / COVERAGE ZONES UNDER THE PLAN
There are 5 different Coverage zones under the plan, defined as follows:
- Zone 5: USA and territories under US jurisdiction (Porto Rico, United States Virgin Islands, Northern Mariana Islands, United States
Minor Outlying Islands, American Samoa) as well as countries of Zones 1, 2, 3 and 4
- Zone 4: Bahamas, Brazil, China, Hong Kong, Jersey, St. Barthelemy, St. Martin, Singapore, Switzerland, United Kingdom and countries
in Zones 1, 2 and 3
- Zone 3: Australia, Austria, Canada, French Polynesia, Greece, Ireland, Israel, Italy, Japan, New Zealand, Portugal Qatar, Russia, Saint
Pierre and Miquelon, Spain, Taiwan, Turkey, United Arab Emirates, Vanuatu and countries in Zones 1 and 2
- Zone 2: Andorra, Angola, Argentina, Azerbaijan, Bahrain, Barbados, Belarus, Belgium, Bolivia, Bosnia and Herzegovina, Bulgaria,
Chile, Colombia, Costa Rica, Croatia, Cyprus, Czech Republic, Denmark, Djibouti, Dominican Republic, Ecuador, Finland, Georgia,
Germany, Guatemala, Hungary, Iceland, Kazakhstan, Kuwait, Latvia, Lebanon, Liechtenstein, Luxembourg, Malaysia, Mexico, Monaco,
Mozambique, Netherlands, Nigeria, Norway, Oman, Panama, Peru, Saudi Arabia, Slovakia, South Africa, Sweden, Thailand, Ukraine,
Uruguay, Venezuela, Vietnam, Wallis and Futuna and countries in Zone 1
- Zone 1: Worldwide (including France) excluding countries in Zones 2 to 5
5
2. / DEFINITIONS OF HEALTHCARE BENEFITS
You will find below the definitions of the terms used in this document (Information Booklet serving as the General Terms &
Conditions).
Accident: Any bodily injury not intended by the person who suffered it, resulting from sudden, unpredictable action with an external
cause. It is the Insured member’s responsibility to provide proof of the Accident and the direct cause-and-effect relationship between
it and the costs incurred.
Acupuncture: Branch of traditional Chinese medicine which consists of inserting needles into specific points on the patient’s body
to relieve various Illnesses or to create an analgesic effect.
Administrator of the plan (administrating organization): Refers to MSH International, a French insurance broker registered with
ORIAS under number 07 002 751, who manages the ASFE plans.
Aggregate limit (on healthcare benefits): The Benefits schedule for the plan stipulates 2 types of benefit limits:
- the Aggregate limit on healthcare benefits refers to the maximum amount the Insurer will pay in respect of all healthcare
benefits (hospitalization & Routine healthcare as well as the Dental and Vision options and Maternity, if selected), per recipient
of the healthcare per Insurance year, for the selected level of healthcare coverage;
- in addition to this Aggregate limit, there are also, for certain benefits, (Routine healthcare + Vision/Dental options and
Maternity) or certain treatments or procedures (consultations, Vaccinations, lenses, frames, etc.) upper limits which are
expressed as a value and/or as a number of days or number of treatments or procedures/sessions which are applied either
per Insurance year, for the life of the plan, per treatment, per procedure or consultation or per day. All upper limits apply per
recipient of the healthcare and per Insurance year, unless otherwise stated in the Benefits schedule.
Alternative medicine: In the plan this refers to: Homeopathy, Acupuncture and Traditional Chinese medicine.
Annual out-of-pocket maximum: The annual out-of-pocket maximum is the maximum amount of cost-sharing that you will have
to pay during the Insurance year.
Annual renewal date: Each anniversary of the effective date of enrollment in the plan.
Application for coverage: Refers to the document confirming the Member’s application for coverage under the plan, and any other
statement made by the primary Member for themselves or for any Dependents listed on the Application for coverage.
Benefits schedule: Document indicating, in respect of the level of healthcare coverage selected by the Member for themselves and
any Dependents, details of the benefits provided under the plan, showing the upper limits, limits on the number of treatments or
procedures, consultations and/or days covered for a given period of time and the Waiting periods, Deductibles, Cost-sharing, Annual
out-of-pocket maximum or Co-payments which apply to them.
Bone density test: Medical examination to measure bone density by assessing bone mineral content (mainly calcium), which is most
commonly performed using a special type of x-ray of the lumbar spine and/or femoral neck. It is used in screening for osteoporosis.
Cancelation period: A Cancelation period is granted to a person who has just enrolled in an insurance plan with optional
membership. A Member may reverse their decision to enroll in an insurance plan for a period of 14 calendar days from the date on
which their Certificate of enrollment is sent out, without having to provide reasons or pay penalties (see section 5.2/ Life of your plan
p.32 in the chapter CANCELING YOUR MEMBERSHIP BEFORE IT TAKES EFFECT: THE CANCELATION PERIOD.
Certificate of enrollment: Single document, issued only at the time of enrollment confirming the Member’s enrollment in the plan
and specifying, as well as the name and address of the Member, and those of any insured Dependents, the Effective date of
enrollment, the benefits selected, the Selected coverage zone, the chosen Deductible and the corresponding Premium. The Certificate
of enrollment corresponds to the special conditions of enrollment in the plan.
Certificate of insurance: Document whose purpose is to serve as proof of insurance cover for the person presenting it. It contains
the following information: name of the Member and any Dependents, Effective date of enrollment in the plan, number and type of
enrollment selected, Insurer of the plan, benefits, Selected coverage zone and chosen Deductible.
Certificate of termination: Document provided to confirm the end of membership of the plan. This certificate is usually required by
the Member’s new health insurer if they switch to another health insurance plan.
CFE: Caisse des Français de l’Etranger, French Social Security body whose purpose and mission is to insure expatriates worldwide.
Childbirth complications: Term used to refer to the following conditions that may occur during childbirth and for which an obstetric
procedure is essential: fetal distress during labor, retained placenta and postpartum hemorrhage. They also include C-section if it is
Medically required. Childbirth complications are only covered if the person receiving the care has Maternity coverage (option
commercialized as ‘HEALTH+CHILD’).
Childbirth without complications: This refers to childbirth not requiring any additional Emergency surgery: fetal distress during
labor, retained placenta and postpartum hemorrhage. C-sections which are not Medically required will be classed as Childbirth
without complications.
Chiropractic: Therapeutic approach which aims to treat a variety of conditions by manipulation.
Chronic conditions: These are conditions whose severity and/or long-term nature require prolonged treatment and costly therapy.
The list of chronic conditions is defined under Article D. 322-1 of the French Social Security Code. This list is provided on page 80 as
an appendix.
Common-law marriage: Union characterized by a continuous, stable, shared life between two persons of the opposite or same sex
who are living together as a couple.
Common-law spouse: Person under the age of 71 on the date of enrollment, who is living in a Common-law marriage with the
Member, whether or not they are in paid employment, if and only if: the Member and their Common-law spouse share the same
home and are free from any other ties of a similar nature (i.e. both partners are single, widowed or divorced and are not bound by a
civil partnership).
If there are several common-law spouses, only the eldest will be recognized.
2. / DEFINITIONS OF HEALTHCARE BENEFITS
You will find below the definitions of the terms used in this document (Information Booklet serving as the General Terms &
Conditions).
Accident: Any bodily injury not intended by the person who suffered it, resulting from sudden, unpredictable action with an external
cause. It is the Insured member’s responsibility to provide proof of the Accident and the direct cause-and-effect relationship between
it and the costs incurred.
Acupuncture: Branch of traditional Chinese medicine which consists of inserting needles into specific points on the patient’s body
to relieve various Illnesses or to create an analgesic effect.
Administrator of the plan (administrating organization): Refers to MSH International, a French insurance broker registered with
ORIAS under number 07 002 751, who manages the ASFE plans.
Aggregate limit (on healthcare benefits): The Benefits schedule for the plan stipulates 2 types of benefit limits:
- the Aggregate limit on healthcare benefits refers to the maximum amount the Insurer will pay in respect of all healthcare
benefits (hospitalization & Routine healthcare as well as the Dental and Vision options and Maternity, if selected), per recipient
of the healthcare per Insurance year, for the selected level of healthcare coverage;
- in addition to this Aggregate limit, there are also, for certain benefits, (Routine healthcare + Vision/Dental options and
Maternity) or certain treatments or procedures (consultations, Vaccinations, lenses, frames, etc.) upper limits which are
expressed as a value and/or as a number of days or number of treatments or procedures/sessions which are applied either
per Insurance year, for the life of the plan, per treatment, per procedure or consultation or per day. All upper limits apply per
recipient of the healthcare and per Insurance year, unless otherwise stated in the Benefits schedule.
Alternative medicine: In the plan this refers to: Homeopathy, Acupuncture and Traditional Chinese medicine.
Annual out-of-pocket maximum: The annual out-of-pocket maximum is the maximum amount of cost-sharing that you will have
to pay during the Insurance year.
Annual renewal date: Each anniversary of the effective date of enrollment in the plan.
Application for coverage: Refers to the document confirming the Member’s application for coverage under the plan, and any other
statement made by the primary Member for themselves or for any Dependents listed on the Application for coverage.
Benefits schedule: Document indicating, in respect of the level of healthcare coverage selected by the Member for themselves and
any Dependents, details of the benefits provided under the plan, showing the upper limits, limits on the number of treatments or
procedures, consultations and/or days covered for a given period of time and the Waiting periods, Deductibles, Cost-sharing, Annual
out-of-pocket maximum or Co-payments which apply to them.
Bone density test: Medical examination to measure bone density by assessing bone mineral content (mainly calcium), which is most
commonly performed using a special type of x-ray of the lumbar spine and/or femoral neck. It is used in screening for osteoporosis.
Cancelation period: A Cancelation period is granted to a person who has just enrolled in an insurance plan with optional
membership. A Member may reverse their decision to enroll in an insurance plan for a period of 14 calendar days from the date on
which their Certificate of enrollment is sent out, without having to provide reasons or pay penalties (see section 5.2/ Life of your plan
p.32 in the chapter CANCELING YOUR MEMBERSHIP BEFORE IT TAKES EFFECT: THE CANCELATION PERIOD.
Certificate of enrollment: Single document, issued only at the time of enrollment confirming the Member’s enrollment in the plan
and specifying, as well as the name and address of the Member, and those of any insured Dependents, the Effective date of
enrollment, the benefits selected, the Selected coverage zone, the chosen Deductible and the corresponding Premium. The Certificate
of enrollment corresponds to the special conditions of enrollment in the plan.
Certificate of insurance: Document whose purpose is to serve as proof of insurance cover for the person presenting it. It contains
the following information: name of the Member and any Dependents, Effective date of enrollment in the plan, number and type of
enrollment selected, Insurer of the plan, benefits, Selected coverage zone and chosen Deductible.
Certificate of termination: Document provided to confirm the end of membership of the plan. This certificate is usually required by
the Member’s new health insurer if they switch to another health insurance plan.
CFE: Caisse des Français de l’Etranger, French Social Security body whose purpose and mission is to insure expatriates worldwide.
Childbirth complications: Term used to refer to the following conditions that may occur during childbirth and for which an obstetric
procedure is essential: fetal distress during labor, retained placenta and postpartum hemorrhage. They also include C-section if it is
Medically required. Childbirth complications are only covered if the person receiving the care has Maternity coverage (option
commercialized as ‘HEALTH+CHILD’).
Childbirth without complications: This refers to childbirth not requiring any additional Emergency surgery: fetal distress during
labor, retained placenta and postpartum hemorrhage. C-sections which are not Medically required will be classed as Childbirth
without complications.
Chiropractic: Therapeutic approach which aims to treat a variety of conditions by manipulation.
Chronic conditions: These are conditions whose severity and/or long-term nature require prolonged treatment and costly therapy.
The list of chronic conditions is defined under Article D. 322-1 of the French Social Security Code. This list is provided on page 80 as
an appendix.
Common-law marriage: Union characterized by a continuous, stable, shared life between two persons of the opposite or same sex
who are living together as a couple.
Common-law spouse: Person under the age of 71 on the date of enrollment, who is living in a Common-law marriage with the
Member, whether or not they are in paid employment, if and only if: the Member and their Common-law spouse share the same
home and are free from any other ties of a similar nature (i.e. both partners are single, widowed or divorced and are not bound by a
civil partnership).
If there are several common-law spouses, only the eldest will be recognized.
6
Contracting association: ASFE. Legal entity having purchased the plan for the benefit of its Members and which agrees to fulfill the
corresponding obligations.
Co-payment: Fixed amount specified in the plan per treatment, procedure or visit which is payable by the Member and their
Dependents. It is applicable per person.
Cost-sharing: Cost-sharing is the percentage of each claim that is not covered by your insurance plan.
Country of nationality: Any country for which the Insured member holds a valid passport and of which they are a citizen, national
or subject, as specified in the Application for coverage.
Date of termination: Date on which the benefits provided under the insurance plan come to an end, on the initiative of the Member,
the Insurer or the Contracting association (see section 5.2/ Life of your plan p.32 in the chapter CESSATION OF MEMBERSHIP AND
END OF COVERAGE (right of withdrawal and termination)).
Deductible: Refers to the amount payable by the Member and any Dependents which is deducted from the reimbursable amount. It
is applicable per person and per Insurance year. If this option is selected it will be specified on the Certificate of enrollment.
Dental surgery: Refers to any Dental surgical procedure with anesthesia including dental extraction and bone or gum grafts.
Dentures and dental implants: Refers to appliances used for fixed reconstruction or repair, bridges, crowns, dentures and implants,
inlays, onlays, inlay cores and any auxiliary treatment required.
Dependent: The following are classed as dependents if they are enrolled in the plan: the Member’s Spouse, Civil partner or Common-
law spouse and Dependent children as defined in this section.
Dependent children: Children of the Member, their Spouse, Partner or Common-law spouse:
Under a FIRST’EXPAT+ plan (1st Euro/Dollar): children under the age of 26 will be considered dependent if they are in full-
time education and are covered under the plan
Under a RELAIS’EXPAT+ plan (in addition to CFE benefits): children under the age of 20 will be considered dependent if
they are in full-time education and are covered under the plan
In all cases, for children over the age of 18 who are in in full-time education and are covered under the plan as Dependents,
a school certificate is required at the time of enrollment and subsequently at the beginning of each academic year.
Dietitian: A qualified health professional specializing in nutrition and food who is officially registered, qualified and recognized in
the country in which they practice and who has the additional experience and qualifications required to deliver this service.
Doctor: Health professional holding a degree of Doctor of Medicine who is authorized to practice medicine under the laws of the
country where the treatment is administered, within the limits of the license they have been granted and who is not a family member
of the person covered under this plan.
Duration of membership: Period of coverage under the plan from the effective date of enrollment shown on the certificate of
enrollment to the date of termination of membership as set out under section 5.2/ Life of your plan p.32 in the chapter CESSATION
OF MEMBERSHIP AND END OF COVERAGE (right of withdrawal and termination).
Effective date of benefits: Date specified on the Certificate of enrollment on which the benefits provided under the plan take effect,
after application of the Waiting periods.
Effective date of enrollment: Date specified on the Certificate of enrollment on which the benefits provided under the plan take
effect.
Emergency: Refers to the medical condition or symptoms resulting from an Illness or injury occurring suddenly and which clearly
requires immediate treatment, usually within 24 hours of onset, without which there would be a risk of endangering the health of
the affected person.
Emergency dental and vision care with hospitalization: Term referring to extremely urgent dental and vision care dispensed
following a serious Accident or the sudden onset of an infection requiring hospitalization. Treatment must be administered within 24
hours of the Accident or infection. This benefit does not cover routine Dental surgery, routine dental care, Dentures, routine vision
care, vision correction, laser vision correction and Orthodontics and Periodontics. These treatments are covered under the optional
Dental/Vision benefits.
Emergency dental and vision care without hospitalization: Term referring to extremely urgent dental and vision care not
requiring hospitalization but which must be administered as an Emergency to relieve pain which is hard to tolerate. This benefit does
not cover routine Dental surgery, routine dental care, Dentures, routine vision care, vision correction, laser vision correction and
Orthodontics and Periodontics. These treatments are covered under the optional Dental/Vision benefits.
Emergency hospitalization: Treatment administered following admission to a Hospital or medical center as a result of the onset of
a sudden and unexpected health concern, following an Illness, Accident, infection, etc.
Emergency treatment outside the coverage zone: Refers to Emergency treatment received in a higher zone than the Selected
coverage zone, during a trip for the purposes of either business or leisure.
Coverage is acquired for a maximum of 60 days per trip and is also limited to the Aggregate limit and only covers treatment required
in the event of an Accident or the onset of a sudden, unexpected and unforeseen Illness, requiring surgery or Medical treatment that
cannot wait until repatriation to the Main country of residence or the worsening of a serious Illness representing an immediate and
serious danger to the health of the Member and/or their Dependents. Treatment dispensed by a General practitioner or a Specialist
must begin within 24 hours of the event which triggered the claim.
The following are therefore not covered by this benefit: non-urgent therapeutic treatment which did not result from an Accident or
unforeseen Illness requiring surgery, or Medical treatment that cannot wait until repatriation to the Main country of residence or the
worsening of a serious Illness representing an immediate and serious danger to the health of the Member and follow-up care, even
in cases where the Member or their Dependents were not able to travel to a country within their Selected coverage zone. Costs
related to Pregnancy, Maternity, childbirth or any other Complication during Pregnancy or childbirth are also excluded from the
benefit. It is recommended that Members and any Dependents contact the Administrator, MSH International, if trips of more than 60
days are planned outside the Selected coverage zone.
Excluded countries: As a result of events (civil or foreign war, insurrection, etc.) which may be taking place there and, in all
circumstances, in accordance with the classification of at-risk countries published by the French Ministry of Foreign Affairs, coverage
Contracting association: ASFE. Legal entity having purchased the plan for the benefit of its Members and which agrees to fulfill the
corresponding obligations.
Co-payment: Fixed amount specified in the plan per treatment, procedure or visit which is payable by the Member and their
Dependents. It is applicable per person.
Cost-sharing: Cost-sharing is the percentage of each claim that is not covered by your insurance plan.
Country of nationality: Any country for which the Insured member holds a valid passport and of which they are a citizen, national
or subject, as specified in the Application for coverage.
Date of termination: Date on which the benefits provided under the insurance plan come to an end, on the initiative of the Member,
the Insurer or the Contracting association (see section 5.2/ Life of your plan p.32 in the chapter CESSATION OF MEMBERSHIP AND
END OF COVERAGE (right of withdrawal and termination)).
Deductible: Refers to the amount payable by the Member and any Dependents which is deducted from the reimbursable amount. It
is applicable per person and per Insurance year. If this option is selected it will be specified on the Certificate of enrollment.
Dental surgery: Refers to any Dental surgical procedure with anesthesia including dental extraction and bone or gum grafts.
Dentures and dental implants: Refers to appliances used for fixed reconstruction or repair, bridges, crowns, dentures and implants,
inlays, onlays, inlay cores and any auxiliary treatment required.
Dependent: The following are classed as dependents if they are enrolled in the plan: the Member’s Spouse, Civil partner or Common-
law spouse and Dependent children as defined in this section.
Dependent children: Children of the Member, their Spouse, Partner or Common-law spouse:
Under a FIRST’EXPAT+ plan (1st Euro/Dollar): children under the age of 26 will be considered dependent if they are in full-
time education and are covered under the plan
Under a RELAIS’EXPAT+ plan (in addition to CFE benefits): children under the age of 20 will be considered dependent if
they are in full-time education and are covered under the plan
In all cases, for children over the age of 18 who are in in full-time education and are covered under the plan as Dependents,
a school certificate is required at the time of enrollment and subsequently at the beginning of each academic year.
Dietitian: A qualified health professional specializing in nutrition and food who is officially registered, qualified and recognized in
the country in which they practice and who has the additional experience and qualifications required to deliver this service.
Doctor: Health professional holding a degree of Doctor of Medicine who is authorized to practice medicine under the laws of the
country where the treatment is administered, within the limits of the license they have been granted and who is not a family member
of the person covered under this plan.
Duration of membership: Period of coverage under the plan from the effective date of enrollment shown on the certificate of
enrollment to the date of termination of membership as set out under section 5.2/ Life of your plan p.32 in the chapter CESSATION
OF MEMBERSHIP AND END OF COVERAGE (right of withdrawal and termination).
Effective date of benefits: Date specified on the Certificate of enrollment on which the benefits provided under the plan take effect,
after application of the Waiting periods.
Effective date of enrollment: Date specified on the Certificate of enrollment on which the benefits provided under the plan take
effect.
Emergency: Refers to the medical condition or symptoms resulting from an Illness or injury occurring suddenly and which clearly
requires immediate treatment, usually within 24 hours of onset, without which there would be a risk of endangering the health of
the affected person.
Emergency dental and vision care with hospitalization: Term referring to extremely urgent dental and vision care dispensed
following a serious Accident or the sudden onset of an infection requiring hospitalization. Treatment must be administered within 24
hours of the Accident or infection. This benefit does not cover routine Dental surgery, routine dental care, Dentures, routine vision
care, vision correction, laser vision correction and Orthodontics and Periodontics. These treatments are covered under the optional
Dental/Vision benefits.
Emergency dental and vision care without hospitalization: Term referring to extremely urgent dental and vision care not
requiring hospitalization but which must be administered as an Emergency to relieve pain which is hard to tolerate. This benefit does
not cover routine Dental surgery, routine dental care, Dentures, routine vision care, vision correction, laser vision correction and
Orthodontics and Periodontics. These treatments are covered under the optional Dental/Vision benefits.
Emergency hospitalization: Treatment administered following admission to a Hospital or medical center as a result of the onset of
a sudden and unexpected health concern, following an Illness, Accident, infection, etc.
Emergency treatment outside the coverage zone: Refers to Emergency treatment received in a higher zone than the Selected
coverage zone, during a trip for the purposes of either business or leisure.
Coverage is acquired for a maximum of 60 days per trip and is also limited to the Aggregate limit and only covers treatment required
in the event of an Accident or the onset of a sudden, unexpected and unforeseen Illness, requiring surgery or Medical treatment that
cannot wait until repatriation to the Main country of residence or the worsening of a serious Illness representing an immediate and
serious danger to the health of the Member and/or their Dependents. Treatment dispensed by a General practitioner or a Specialist
must begin within 24 hours of the event which triggered the claim.
The following are therefore not covered by this benefit: non-urgent therapeutic treatment which did not result from an Accident or
unforeseen Illness requiring surgery, or Medical treatment that cannot wait until repatriation to the Main country of residence or the
worsening of a serious Illness representing an immediate and serious danger to the health of the Member and follow-up care, even
in cases where the Member or their Dependents were not able to travel to a country within their Selected coverage zone. Costs
related to Pregnancy, Maternity, childbirth or any other Complication during Pregnancy or childbirth are also excluded from the
benefit. It is recommended that Members and any Dependents contact the Administrator, MSH International, if trips of more than 60
days are planned outside the Selected coverage zone.
Excluded countries: As a result of events (civil or foreign war, insurrection, etc.) which may be taking place there and, in all
circumstances, in accordance with the classification of at-risk countries published by the French Ministry of Foreign Affairs, coverage