first time surrogate marie - international surrogacy center...first time surrogate marie proven: no,...

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First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has an Anthem Blue Cross policy through her employer that needs to be reviewed for Surrogacy coverage upon matching. Travel: Yes, to all clinics Lost Wages: $22.12/ per hour Restrictions: None Languages: English Interview: Marie is an amazing mother to her 4 children; Ian is 13, Cadence is 11, Raegan is 9 and Jaxson is 5. She and her husband Shawn have been married for 13 years. They love spending time together as a family watching their son play football, going to the movies and hanging out at Disneyland. Marie is funny, outgoing and honest. She is extremely dedicated to this process and wants to fulfill her dream of becoming a Surrogate. She is eager to help you fulfill you dream of having your own family!

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Page 1: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has

First Time Surrogate Marie

Proven: No, first time Surrogate

Location: Winchester, CA

Age: 37

Insurance: Surrogate has an Anthem Blue Cross policy through her employer that needs to be

reviewed for Surrogacy coverage upon matching.

Travel: Yes, to all clinics

Lost Wages: $22.12/ per hour

Restrictions: None

Languages: English

Interview: Marie is an amazing mother to her 4 children; Ian is 13, Cadence is 11, Raegan is 9

and Jaxson is 5. She and her husband Shawn have been married for 13 years. They love

spending time together as a family watching their son play football, going to the movies and

hanging out at Disneyland. Marie is funny, outgoing and honest. She is extremely dedicated to

this process and wants to fulfill her dream of becoming a Surrogate. She is eager to help you

fulfill you dream of having your own family!

Page 2: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 3: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 4: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 5: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 6: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 7: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 8: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 9: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 10: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 11: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
Page 12: First Time Surrogate Marie - International Surrogacy Center...First Time Surrogate Marie Proven: No, first time Surrogate Location: Winchester, CA Age: 37 Insurance: Surrogate has
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International Surrogacy Center Marie

Fee Details _ . Monthly TotalSurrogate Base Compensation (once in contract, $50,000.00 will need to be paid to your escrow/fund account for your

Surrogate's compensation, this is an estimated amount and could be more or less depending on the Surrogate and the pregnancy)

Please see below for the different compensations for your Surrogate.

First Time Surrogate Paid as $3,000.00 per month as long as the Surrogate is pregnant, $3,000 $30,000with the first payment due on the 1st of the month following

confirmation of pregnancy by ultrasound fetal heartbeat and the

balance paid within two weeks (14 days) after birth.

Additional Payments made to the Surrogate Start of Medications Start of hormonal Medications: Surrogate will be compensated $500 $500

$500.00 upon starting hormonal medications (not birth control).

If more than onc cycle is needed, Surrogate will be compensated

for each cycle, only if the need for another cycle is no fault

of the Surrogate's. This compensation will not be given

for a mock cycle.

Embryo Transfer Fee Surrogate will be paid $1,000.00 as an additional non- $1,000 $1,000acountable expense allowance on the first of the month after

each embryo transfer procedure to reimburse Surrogate for any

lost wages, and miscellaneous expenses, such as childcare

and housekeeping while she is restricted to bed by the

IVF physician as a result of the embryo transfer procedure.

Notary Fee for Contract Surrogate is entitled to out of area mileage and notary fee up to $100 up to $100

Maternity Clothing Allowance Payable on the first of the month following the 18th week $800 $800 (singleton) or 16 weeks (multiples) after embryo transfer

and increases $200 if surrogate is carrying multiples.

Monthly Payments made to the Surrogate Monthly Misc Allowance Non-accountable monthly expense allowance is intended to $300 $4,500

cover miscellaneous expenses relating to the surrogacy

arrangement such as local travel, telephone charges,

postage, fax charges, childcare charges for doctor and lab

appointments, non-prescription vitamin/supplements and over

the counter products. This expense allowance will start on the

first of the month following the signing of the Agreement and

end one month after birth or when the Agreement is terminated.

Estimated for 15 months.

Housekeeping Beginning the 1st week of the 3rd trimester till one payment after $160 $560 delivery, surrogate shall be paid a Bi-weekly (every-other week)

Housekeeping Allowance. Estimated of 7 payments and ends

one payment after delivery.

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Surrogate Support Group or Surrogate shall receive $100.00 for every month that she $100 $1,500psychological support participates in support group meetings. The payments

begin the month the contract is signed with the IPs

and continues through 3 months following the birth of the

child(ren). If needed, psychological support will be reimbursed in

lieu of surrogate support group compensation.

Potential out of City CostsMileage If the Surrogate travels more than 50 miles round-trip from her Actual Costs Actual Costs

home for required activities, in addition to her monthly

expense allowance she will be reimbursed for her mileage

at $.50 per mile.

Meals Reimbursement for a meal when traveling to the clinic up to $25/trip Actual costs $25 per day with receipt

Possible Additional CostsCancelled Cycle Fee If cycle is cancelled due to no fault of the Surrogate, and she has $500 $500

already begun taking hormonal medication (exluding birth control)

Invasive Procedure Per procedure, includes amniocentesis, cvs, cerclage, abortion $500 $500fetal reduction, D&C, uterine biopsy, cyst aspiration

C-Section Physician Recommended. Inclusive of childcare and $3,000 $3,000 housekeeping (C-section fee is not inclusive of lost wages)

Multiples Fee Per additional child carried and paid in monthly installments of $1,000 $7,000 $1,000.00 per month, starting 1st of the month following 18th

week gestation.

Miscarriage Fee In the event the Surrogate has a positive HCG blood test but $500 $500there is no fetal heartbeat detected upon ultrasound, or should

a miscarriage occur prior to her receiving her first pregnancy

payment.

Loss of Uterus In the event the Surrogate looses her uterus as a direct result of $8,000 $8,000the Surrogacy, no more than 120 days after delivery or

termination of pregnancy.

Mock Cycle Fee If the IVF doctor requires the Surrogate to undergo a mock $500 $500 cycle.

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Bedrest Housekeeping, Childcare, or Other Expenses: In the event that $250/week Actual CostSurrogate’s treating physician orders, in writing, bed rest or

restriction of Surrogate’s activities, the Intended Parents will

reimburse the Surrogate for her reasonable expenses incurred

for activities she cannot perform, such as housekeeping and

childcare during the period of bed rest or inability to work.

The maximum available to the Surrogate during this period of

restricted activity is $250/week. The maximum time this benefit

will extend is 6 weeks after a vaginal delivery, miscarriage or

abortion, or 8 weeks after a C-Section birth.

Lost Wages For physician ordered bed rest after a pregnancy is achieved. $22.12/per hour Actual Costs Surrogate must provide recent paycheck stubs to attorney to

qualify for lost wages. Lost wages are paid 6 weeks after a

vaginal delivery and 8 weeks after a C-sections.

IVF Clinic Visit Fee Working Surrogate is compensated $40 per IVF visit and Labs; this $40.00/per visit Actual costfee ends upon confirmation of fetal heartbeat via ultrasound.

Additional Benefits and Medical Costs Life Insurance $250,000 policy for the Surrogate and $100,000 policy for the Ips $450 $450

( to recoup medical bills), policy is for 18 months and can be

extended if needed at $25.00/month. This is a one-time payment.

Breastmilk Compensation If requested by intended parents, and agreed upon by surrogate, $250/Week $250/week will be compensated $250 a week, and parents will also

provide shipping costs, breast pump and any other

materials needed for the process

Special Requests Any special requests such as organic food Actual Costs Actual Cost

Screening Costs for your Surrogate (criminal and psychological must be paid to the agency upon matching wth your Surrogate)

Psychological Evaluation Psychological screening of Surrogate and spouse/partner $1,500 $1,500Criminal Background Check Criminal screening of Surrogate and spouse/partner $400 $400Surrogate Contract Review Paid for Surrogate to review contract with her attorney. (Paid $1,000 $1,000

from IPs escrow/fund account)

Health Insurance (To be used by Surrogate for maternity care, this does NOT cover the baby/s health care)

Note that insurace premiums and deductibles are subject to annual review and can increase to refelct changes of the cost of

Health Insurance. This insurance does NOT cover the costs for IVF, medication involved with IVF, fertility testing, or for the care

of the newborn.

Insurance Monthly Premium N/A Actual CostSurrogate has an Anthem Blue Cross policy through her employer that needs to be reviewed for

Surrogacy coverage upon matching. If Surrogacy is covered then IP's will not be responsible for

mothly premiums but will pay all copays and deductibles. If Surrogacy is not covered then IP's will pay cash

for OB care until Surrogate can apply for a new policy. IP's will be responsible for the new monthly premiums

on this policy as well as all copays and deductibles.

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Copays & Deductible Deductibles vary and can range from $1,000 - $7,000. The IPs 1,000- 7,000 Actual Costresponsible for the co-pays and deductible.

International Surrogacy Center is not an insurance agency, therefore, any information on insurance is provided only to help customers understand

the potential costs associated with health insurance. ISC is not responsible for the denial or exclusion of coverage of an insurance company.

ISC is not responsible for the lack of adequate insurance covergae, it is hghly recommended to contact our insurance specialist (contact information

will be provided) or deposit additional funds in the Escrow account to cover medical and hospital expenses for their Surrogate.

Agency Fee (Includes all administration fees)

ISC Agency Fee One time fee, must be paid once your Surrogate has been medically cleared. $19,500Baby InsuranceTwo Options Available 1) Pay Cash for the baby's health care and have your lawyer help Actual Cost

you negotiate with the hospital for lower fees.

2) Contact our insurance specialist to purchase a baby insurance policy.

This is highly suggested if your Surrogate is carrying twins.

**A Newborn will NOT be covered by the Surrogate's Health Insurance Policy**

The costs listed on this fee sheet are estimates only and may not include all costs associated with the gestational surrogacy process. Complications

(ie. Multiple births, difficulty of stimulation of the donor/pregnancy, high-risk pregnancies. etc.) add to the costs of the surrogacy process.

Timeline for Fees:

1. If the above Surrogate needs to apply for Health Insurance, there is a $350.00 fee charged by the Insuranceagency. This fee is to help the Surrogate apply for the Insurance plan as well as work with the Ips to find the best health insurance option for the Surrogate. If the surrogate needs her own Insurance policy reviewed, tocheck to see if Surrogacy will be covered, there is a $350.00 fee for this review.

2. $1,900.00 due once IPs and Surrogate have agreed to match, this amount is paid to the agency to pay for the criminal and psychological screening for your Surrogate.

3. $19,500.00 due once your Surrogate is medically cleared by the IVF clinic.

4. Once Surrogate and IPs have signed the legal contract IPs must fund their escrow/funds account $50,000.00this covers their surrogates compensations during the surrogacy. If Surrogate requires more than one embryo transfer , Ips need to make sure the fund account is at $50,000.00 before start of each transfer.

5. We will send a final estimation to IPs in the third trimester of pregnancy. This final estimation showswhat has already been paid, if there are more funds needed based on the situation of the pregnancy or it will show the overage projected after delivery.

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