Because so many students come to school without health insurance, it is this University’s requirement to make sure students have health insurance coverage while your student attends Hollins University.

Hollins University provides student health insurance coverage and the cost of this Plan will automatically be added to the tuition bill. If you have other comparable coverage and do not want this insurance premium added to your bill, please complete, sign and mail the Waiver Form which is enclosed in this package.

You may choose to maintain health insurance independently or purchase the Hollins  University health insurance plan. Before waiving the student health insurance plan, please take a moment to consider the following: Does your family health insurance Plan pay 100% of all medical expenses? If your insurance does not pay 100% of medical expenses frequently incurred by this age group, consider purchasing this Plan. It is designed to help cover these expenses and can fill in the gaps by covering your family plan deductible and coinsurance.

Eligibility

All full-time undergraduate students, Horizon students, and residential graduate students enrolled at Hollins University are included in this insurance Plan and the premium for coverage is added to the tuition billing unless proof of comparable coverage is furnished with the "Proof of Insurance” form to the Student Affairs Office by July 13, 2007 (which is non-refundable). Graduate students, other than resident, are highly encouraged to carry this insurance.

Eligible students enrolled in the Plan may also insure their dependents. Eligible dependents are the spouse and unmarried children under the age of 19 who are not self-supporting and reside with the insured student. Newly born children of the insured person are covered for the first 31 days after birth.

Refund Provision

In the event an Insured person leaves the school to enter active military service, coverage will cease and a pro rata refund of premium will be made upon request. Other than as stated here, no refunds are available.

Terms of Coverage

The policy for the current year becomes effective on August 13, 2007 at 12:01 a.m. and expires on August 13, 2008 at 12:01 a.m. Coverage remains in effect during holiday and vacation periods. Should an Insured person graduate or withdraw from the institution, the insurance shall remain in effect until the end of the period for which premium has been paid. The Plan protects the Insured students of Hollins University at home, at school, or wherever they are 24 hours a day.

Waiver Deadline

If you have proof of comparable insurance and wish to waive coverage, the deadline to waive out of this Plan is July 13, 2007.For students beginning their studies in the Spring semester, the deadline is January 3, 2008.

Undergraduate Annual Cost

Graduate Annual Cost

Definitions

DEDUCTIBLE means the dollar amount of Covered Medical Expenses that must be paid as an out-of-pocket expense by each Covered Person per Injury or Sickness each Policy Year before benefits are payable under this Policy. The Deductible Amount is shown on the Schedule.

HOSPITAL means an institution which meets all of the following requirements:

(1) it must be operated according to law;
(2) it must give 24 hour medical care, diagnosis and treatment to the sick or injured on an in-patient basis for which a charge is made;
(3) it must provide diagnostic and surgical facilities supervised by Physicians;
(4) Registered Nurses must be on 24 hour call or duty;
(5) the care must be given either on the Hospital's premises or in facilities available to the Hospital on a pre-arranged basis.

A Hospital is not a rest, convalescent, extended care, rehabilitation or skilled nursing facility. It is not a place which primarily treats mental illness, alcoholism or drug addiction; nor does it include any ward, wing or other section of the Hospital that is used for such purposes. It is not a facility where, in the absence of insurance, there is no legal obligation to pay.

INSURED means an eligible student as outlined in this Policy and in the Master Application for whom an application has been received and has paid the required premium. The words he, his, and him refer to the Insured, regardless of gender.

INJURY means bodily Injury caused by an accident. The accident must occur while the Covered Person's insurance is in force under this Policy. All injuries sustained by one person in any one accident, including all related conditions and recurrent symptoms of these Injuries, are considered a single covered Injury. The Injury must be the direct cause of loss and must be independent of all other causes. The Injury must not be caused by or contributed to by Sickness.

MEDICALLY NECESSARY means care which a Physician has determined to be certifiably essential for the diagnosis or treatment of a Sickness or Injury. This determination must be based on objective results produced by an examination of the Covered Person's demonstrable symptoms. The Physician's treatment plan may be reviewed by an impartial third party whose determination will be binding on us and the Insured.

PHYSICIAN means a person licensed by the state in which he is resident to practice the healing arts. He must be practicing within the scope of his license for the service or treatment given. Physician shall also include a Dentist performing covered services within the scope of his professional license. He may not be the Insured or a member of his Immediate Family.

SICKNESS means an illness, or disease which first manifests or causes a loss while this Policy is in force and which results in Covered Medical Expenses. All related conditions and recurrent symptoms of the same or a similar condition will be considered the same Sickness. It also includes Pregnancy and Complications of Pregnancy.

USUAL AND CUSTOMARY CHARGE means those charges for necessary treatment and services that are reasonable for the treatment of cases of comparable severity and nature. This will be derived from the mean charge based on the experience in a related area of the service delivered.

Continuation of Coverage

If a Covered student no longer meets the Policy’s eligibility requirements, he or she may continue coverage for three (3) months provided the school renews the Master Policy with Monumental Life Insurance Company. The student must notify us that he or she wishes to continue coverage under this Policy and pay any required premium within thirty(30) days of ineligibility under the Policy’s requirement.

Extension of Benefits After Termination

The coverage provided under this Policy ceases on the termination date. However, if a Covered Person is Hospital Confined on the termination date from a covered Injury or Sickness for which benefits were paid before the termination date, Covered Medical Expenses for such Injury or Sickness will continue to be paid until the completion of his Hospital Confinement as long as the condition continues for the duration of recovery but not to exceed 9 months from the expiration date of cover-age or beyond release from the Hospital for that Inpatient Confinement or the maximum policy benefit whichever occurs first.

Mandated Benefits

Biological Based Mental Illness Benefit; Bones and Joint Treatment Benefit; Cancer Clinical Trail Benefit; Colorectal Cancer Screening Benefit; Cytology Benefit; Dental Anesthesia Benefit; Diabetes Coverage Benefit; Hemophilia and Congenital Bleeding Disorders Benefit; Hysterectomy Benefit; Hospice Care Benefit; Lymphedema Benefit; Mammography Benefit; Mastectomy Length of Stay Benefit; Mastectomy Reconstruction Benefit; Mental Health and Substance Abuse Benefit; Pregnancy from Rape or incest Benefit; Prostate Cancer Screening Benefit; Child Health Supervision services Benefit; Cleft Lip and/or Cleft Palate Benefit; Early Intervention Benefit; Infant Hearing Screening Test Benefit; Newborn Immunization Benefit.

Emergency Evacuation Benefit

We will pay for Covered Emergency Evacuation Expenses incurred if the insured person suffers an injury or Sickness that requires Emergency Evacuation while on Covered Travel. Benefits payable are subject to a Maximum Amount per Insured Person of $50,000 for all Emergency Evacuations due to all injuries from the same Accident or all Sicknesses from the same or related causes, and this is also the Aggregated Maximum for all travel benefits including Medically Necessary Transportation, Family Visitation Expense, and the Repatriation of Remains Benefit.

Medically Necessary Transportation

If the Insured person is hospitalized for more than 5 consecutive days following a Covered Emergency Evacuation, we will pay, subject to any limitations stated herein, for Expenses to return the Insured person from the medical facility to which he or she was treated tot he Insured person's return destination, less refunds from the Insured person's unused transportation tickets. Airfare costs will be economy or first-class if the insured person’s original tickets are first class.

Family Visitation Expense
If the insured person is unable to travel due to a Covered Emergency Evacuation, we will pay, subject to any limitation stated herein, for Expenses to bring a family member to and from the Hospital or other medical facility where the insured person is confined, not to exceed the cost of one round-trip economy airfare ticket. The aggregated maximum payable for this benefit if $1,000.

Repatriation of Remains Benefit

If the insured person suffers a covered loss of life while on Covered Travel, we will pay subject to the limitations stated below, for Covered Expenses reasonably incurred to return the insured person’s body to their home country, but not exceeding a Maximum Per Insured person benefit amount of $50,000, and this is also the Aggregated Maximum for all travel benefits including the Emergency Evacuation Benefit, Medically Necessary Transportation, and Family Visitation Expense.

Covered Expenses: Covered Expenses include, but are not limited to, Expenses incurred in accordance with the applicable international requirements for; (1) embalming; (2) cremating; (3) the most economical coffins or receptacle adequate for transportation of the remains; and (4) transportation, according to airline tariffs, of the remain by the most direct and economical conveyance and route possible.

Benefits will not be provided for any Expense provided by another party at no cost to the Insured person or already included in the cost of the Covered Travel.

We or Our representatives must authorize all Expenses in advance for any travel benefit to be payable.

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
• Hospital Admission Guarantee
• Critical Care Monitoring
• Family/Friend transportation
• Emergency Message Transmission
• Prescription Medication Dispatching
  
  Within North America Call 1-800-407-7307
  Outside North America Call 1-603-898-9159

Note: The Travel Assistance program is not insurance. It is not connect with or provided by Monumental Life Insurance Company. On Call International benefits are availa ble 24 hours a day, 7 days a week, 365days a year.

Coordination of Benefits

EXPLANATION When a person is covered by more than one Plan, the benefits that are paid will be shared between the Plans. This is done so that the total benefits paid will not be more than 100 percent of the Allowable Expenses for any Covered Person. In a Policy Year this Policy will pay:

1. its regular benefits in full; or(
2. a reduced amount of benefits if a Covered Person is covered under more than one Plan. If a reduced amount of benefits is paid using this provision, each benefit that would be payable in the absence of this provision:
   1. will be reduced to the same proportion;
   2. the reduced amount will be charged against any benefit limit of this Policy that applies.

EFFECT ON BENEFITS This provision will be used to deter-mine a Covered Person's benefits for any Policy Year when the sum of the following is more than the Allowable Expenses:

1. the benefits that would be paid under this Policy in the absence of this provision; and
2.  the benefits that would be paid under all other Plans in the absence of similar provisions whether or not a claim is made. When a Plan provides benefits in the form of services rather than cash payments, the reasonable cash value of each service given will be considered as a benefit paid.

The benefits of another Plan that co-ordinates its benefits with this Policy will be ignored in order to determine the benefits under this Policy if:

1. another Plan provides that its benefits be paid after the benefits of this Policy; and
2. this Policy provides that its benefits be paid before such other Plan.

ORDER OF BENEFIT DETERMINATION The plan that pays first figures its benefits exactly as though duplicate cover-age does not exist. The second Plan will pay for Allowable Expenses not covered by the first Plan if this amount is not more than the benefits payable when there is no duplicate coverage. When two or more Plans contain non-duplication clauses, the order in which the Plans will pay benefits will be as follows:

1. a Plan that covers the person as other than a Dependent will pay before a Plan that covers the per-son as a Dependent;
2. a Plan that covers the person as a Dependent of a person whose birthday falls earlier in a year will pay before a Plan that covers the person as a Dependent of a person whose birthday falls later in that same year, except that:
   1. a Plan that covers a child as a Dependent of the parent with custody will pay before a Plan that covers the child as a Dependent of the parent without custody. This occurs when the parents are separated or divorced and the parent with custody has not remarried;
   2. a Plan that covers a child as a Dependent of the parent with custody will pay before a Plan that covers the child as a Dependent of the stepparent. A Plan that covers the child as a Dependent of the stepparent will pay before the benefits of a Plan which covers the child as a Dependent of the parent without custody. This occurs when the parents are divorced and the parent with custody has remarried;
   3. however, a Plan that covers a child as a Dependent of the parent who is financially liable will pay before any other Plan that covers the child as a Dependent child. This occurs when there is a court decree which would otherwise establish financial liability for the medical, dental or other health care expenses of the child; and
3. the first Plan to pay when the order of payment cannot be determined by these rules will be the Plan that has covered the person for the longer period of time.

RIGHT TO RECEIVE AND RELEASE NECESSARY INFORMA-TION In order to determine whether this provision applies the Company may.

1.  release or obtain any necessary information from any other organization or person with a legitimate interest;
2. require any person claiming benefits to furnish such necessary information; and
3. receive information reasonably related to a claim for benefits under this Plan.

FACILITY OF PAYMENT The Company has the right to make payments to any organizations when payments have been made under any other Plans and should have been made under this Policy.

Payment will be in any amount determined by the Company to be warranted. The amounts paid will be considered benefits paid and the Company will be liable only to the extent of payment made.

RIGHT OF RECOVERY The Company may recover any payments it makes in excess of the amount needed to satisfy the intent of this provision from among one or more of the following:

1. any person that receives payments; or
2.  any other insurance companies or other organizations.

Conformity of State Statutes

Any provisions of this plan of insurance which on its effective date, is in conflict with the statutes of the state in which it is issued is hereby amended to conform to the minimum requirements of such statutes.

Any Expense not specifically listed in the preceding sections is not covered.

Exclusions

1. Expenses incurred as the result of dental treatment, except as specifically provided for treatment resulting from Injury to natural teeth;
2.  Services that are provided normally without charge byte University's health center, infirmary or Hospital; or by any person employed by the University;
3.  Eyeglasses, radial keratotomy, contact lenses, hearing aids or prescriptions or examinations except as required for repair caused by a covered Injury;
4.  Routine physical examinations, preventive testing or treatment, screening exams or testing in the absence of Sickness or Injury, pre-marital examinations, pre-employment examinations, health examinations or pre-school physical examinations including routine care of a newborn infant, well baby nursery and related Physician charges, other than Hospital nursery expense of a newborn baby, and any associated laboratory work, not including mammograms and routine Papanicolaou cytology test;
5. Cosmetic surgery, except for the correction of birth defects, correction of deformities resulting from cancer surgery, or surgery that is required as a result of an Injury which necessitates medical treatment within 24hours of the accident. Correction of deviated nasal septum shall be considered as Cosmetic surgery for the purpose of this Policy;
6. Elective abortion;
7. Injury resulting from racing or speed contests, skin diving or sky diving, or any other hazardous sport or hobby;
8. Declared or undeclared war, riot, civil disorder, civil commotion;
9. Committing or attempting to commit an assault or felony; or fighting, except in self defense;
10.  Suicide or attempted suicide while sane or insane, including drug overdose; or intentional self-inflicted Injury (except in Colorado and Missouri, while sane).
11. Injury sustained or Sickness contracted while in the service of the armed forces of any country. When an Insured enters the armed forces, we will refund any unearned pro-rata premium with respect to such per-son;
12. Injury or Sickness for which benefits are payable under any Workers’ Compensation or Occupational Disease Law;
13. Taking of any drug, medication, narcotic or hallucinogen, unless as prescribed by a Physician;
14.  Taking of alcohol in combination with any drug, medication or sedative;
15.  Treatment provided in a government hospital unless there is a legal obligation to pay such charges in the absence of other insurance;
16. Injury resulting from the playing, practice, participating, or conditioning in any intercollegiate, contest or competition sponsored by the University, any professional or semi-professional sport, or Injury sustained while traveling to or from such sport, contest or com-petition as a participant;
17. Outpatient Physiotherapy, except for a condition that required surgery or Hospital Confinement: 1) within the 30 days immediately preceding such Physiotherapy; or 2) within the 30 days immediately following the attending Physician’s release for rehabilitation. This exclusion applies to accumulative expenses incurred above $500;

Claim Procedures

In the event of an Injury or Sickness, in a non-emergency situation, the Insured Person should:

1. Complete a claim form, which is available on-line at our website, www.BollingerInsurance.com/Hollins. Please read and follow the instructions provided on the back of the claim form carefully.
2. The claim form must be completed and signed. Written proofs of loss (itemized bills) must be furnished with the claim within 90 days from the date of loss. Mail the claim to the address on the form.
3. Preauthorization and pre-certification of the benefits to providers of medical service are not required nor pro-vided by us.
4. No claim will be processed until a Bollinger, Inc. claim form is received.

For Information contact the Plan Administrator:

P.O. Box 727
SHORT HILLS, NJ 07078-0857
(866) 267-0092 (Claims/Coverage)
(800) 526-1379 (Other Questions)

Preferred Provider Network;

PLEASE PRINT OUT THIS BROCHURE AND KEEP IT AS A GENERAL SUMMARY OF THE INSURANCE BENEFITS. The Master Policy on file at the University 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 Policy, the Master Policy will govern and control the payment of benefits.