CRITICAL ILLNESS & ACCIDENTAL BENEFITS PROGRAM

Transcription

1 CRITICAL ILLNESS & ACCIDENTAL BENEFITS PROGRAM

2 BENEFITS Accidental Death and Dismemberment $10,000 Accidental Death and Dismemberment benefit pays up to the amount shown for the active Member and the Member s spouse. Coverage is 24 Hours a Day, 365 Days a Year, anywhere in the world. This benefit is paid in addition to any other coverage. Coverage ends at age 70. Accident-Only Medical Expense Benefit $10,000 This benefit provides up to $10,000, less a $100 deductible, for Usual and Customary Covered Expense that result directly from an accidental injury, to the extent that the expenses are not covered under certain existing insurance that a member may have. Members can use this benefit for expenses that include: emergency ambulance service, hospital, doctors treatment, x-ray and lab, drugs, nursing care, physical therapy, and more. Must file a claim with all other carriers first and the first charge must be incurred within 180 days of the Covered Accident. Coverage ends at age 70. Critical Illness $10,000 The Critical Illness Indemnity Benefit provides a lump sum payment when the member is diagnosed with a life threatening illness, such as cancer, heart attack, kidney renal failure, major organ transplant or stroke. Benefits are not payable for a pre-existing condition for six months. Benefits reduce by 50% from age Coverage ends at age 70. Equal coverage for the Member and the Member s spouse. The above coverages are underwritten by Starr Indemnity & Liability Company, a Texas insurance company, which has its principal place of business at 399 Park Avenue, New York, New York It is currently authorized to transact business in all states, District of Columbia and Puerto Rico. NAIC No See page 3 for a list of exclusions. The coverages described in this document are only a brief description of available insurance coverage. It is intended for general information purposes and does not provide any guidance regarding coverage that may or may not be available under this policy in respect to any claim. Any Policy issued by Starr Indemnity & Liability Company will contain limitations, exclusions and termination provisions. Not all coverages available in all jurisdictions. For costs and complete details of specific policy coverage, please contact your insurance professional. BridgeHealthMedical Save On Major Surgery Costs With BridgeHealth BridgeHealth, the premier provider of medical travel services, connects you with domestic and international hospitals and doctors to provide you with excellent quality and pricing that is substantially lower than anything you can find on your own. We provide you with a connection to our pre-screened network of providers, we schedule the surgery/procedure for you, and provide personal assistance throughout the entire experiencefrom the initial contact with the surgeon, to trip planning, updates to friends and family, and follow-up care.

3 Best Doctors You and your doctor have access to the medical guidance of over 50,000 of the leading medical specialists in over 400 subspecialties of medicine. This benefit provides you with the following services: InterConsultationTM - a high level second opinion, to confirm diagnosis and treatment. FindBestDocTM - assistance in locating doctors in your area that thave been identified as best by their peers to treat specific medical conditions. FindBestCare - arranging access to hospitals and treatment. BEST DOCTORS, INFORMATION WHEN IT MATTERS MOST, the Best Doctors Logo, FINDBESTDOC, INTERCONSULTATION, and FINDBESTCARE are trademarks or registered trademarks of Best Doctors, Inc. in the U.S. and other countries, and are used under license. Dignity Memorial Dignity Memorial is a nationwide network of over 1,800 funeral, cremation, and cemetery service providers. 1 Members receive 10% savings on funeral or cremation services and merchandise including cemetery interment rights, services and merchandise through Dignity Memorial affiliated cemeteries, a free 2 Funeral Protection Certificate for your children and grandchildren worth up to $2,500, a Family Planning Guide, access to an extensive Grief Management Library and Family Safety Programs, Funeral and cremation preplanning services that are transferable to Dignity Memorial location throughout the United States (must be over 75 miles from the location where prearrangements were made). Substantial savings on bereavement airfares, extended family coverage. 1 Where available by law. 10% savings does not apply to cash advance items or already discounted Dignity Memorial plans. Not available in the state of LA and may not be available in NY. 2 Not available in MD. USA+ BENEFITS PROTECTOR BENEFITS PROTECTOR Many individuals lose their job due to a company re-location, company downsizing or as the result of natural disasters. For most individuals, loss of employment also means a monetary loss. The Benefits Protector program helps cushion the impact of economic downturns that occur. Should you lose your job through no fault of your own, we will be there for you. Your membership dues will be waived and your membership benefits will continue for three (3) months. (Certain Terms and Conditions Apply). The USA+ membership is not an insurance contract. The membership includes insured & non-insured benefits. This is an Association membership offered and administered by united Service Association For Health Care, P.O. Box , Arlington, TX , 800-USA Not available in all states. Please contact USA+ for state availability.

4 CRITICAL ILLNESS AND ACCIDENTAL DEATH & DISMEMBERMENT BENEFIT EXCLUSIONS Critical Illness Insurance Exclusions and Limitations: In addition to any other conditions, exclusions or limitations set forth in the Coverage, no coverage will be provided if the Covered Condition is caused by, occurs during or results from: a. Participation in the commission or attempted commission of a felony. b. Voluntary participation in a riot or insurrection. c. Refusing certain types of recommended medical treatment, as follows: i. A Physician has recommended treatment with angioplasty or coronary artery bypass graft for coronary artery disease, the Covered Person refuses this treatment, and the Covered Person suffers a Heart Attack; ii. A Physician has recommended treatment for a brain aneurysm or carotid artery stenosis, the Covered Person refuses treatment, and the Covered Person suffers a Stroke; or iii. A Physician has recommended a diagnostic biopsy or diagnostic/therapeutic excision of a mass or lesion suspected of being Cancerous, the Covered Person refuses, and the Covered Person develops Cancer. In addition to the Preexisting Condition Limitation described above, no Coverage Amount is payable for an otherwise Covered Condition if: a. Such Covered Condition has not been Diagnosed by a Physician; b. Such Covered Condition was not Diagnosed until the Coverage had terminated; or c. The Covered Person s date of birth or age was misstated on the application and, using the correct date of birth or age, the Coverage would not have become effective or would have terminated prior to Diagnosis of a Covered Condition. If a Covered Person can recover benefits under more than one of the Coverage Amounts as stated in this Rider, the most We will pay for these benefits in total is the Covered Person s Maximum Benefit Amount. Accidental Death and Dismemberment Exclusions: The Policy does not cover any Loss caused or contributed by: 1. sickness or treatment of a sickness, as described in the definition of Injury; 2. intentionally self-inflicted Injury; 3. suicide or attempted suicide, whether sane or insane; 4. war or act of war, whether declared or not; 5. Injury sustained while on active duty as a member of the armed forces (land, water, air) of any country or international authority except Reserve National Guard Service; (We will refund the pro rata portion of any premium paid for You [or Your Dependents] while You [or Your Dependents] are in the armed forces on active duty. Written notice must be given to Us within 12 months of the date You [or Your Dependents] enter the armed forces.); 6. Injury sustained while on any aircraft except a Civil or Public Aircraft, or Military Transport Aircraft; 7. Injury sustained while on any aircraft: a. as a pilot, crewmember or student pilot; b. as a flight instructor or examiner; c. if it is owned, operated or leased by or on behalf of the Policyholder; d. being used for tests, experimental purposes, stunt flying, racing or endurance tests; 8. Injury sustained while taking drugs, including but not limited to sedatives, narcotics, barbiturates, amphetamines, or hallucinogens, unless as prescribed by or administered by a Physician; 9. Injury sustained while riding or driving in a scheduled race or testing any Motor Vehicle on tracks, speedways or proving grounds; 10. Injury sustained while committing or attempting to commit a felony; 11. Injury sustained while Intoxicated; or 12. Injury sustained while driving while Intoxicated. Intoxicated means: 1. the blood alcohol content; 2. the results of other means of testing blood alcohol level; or 3. the results of other means of testing other substances that meet or exceed the legal presumption of intoxication, or under the influence, under the law of the state where the accident occurred. Reserve National Guard Service means: You or Your Dependents are : 1. attending or en route to or from any active duty training of less than sixty (60) days; 2. attending or en route to or from a service school of any duration; 3. taking part in any authorized inactive duty training; or 4. taking part as a unit member in a parade or exhibition authorized by official orders. BENEFITS NOT AVAILABLE IN ALL STATES. PLEASE CONFIRM AVAILABILITY PRIOR TO ENROLLMENT The coverages described in this document are only a brief description of available insurance coverage. It is intended for general information purposes and does not provide any guidance regarding coverage that may or may not be available under this policy in respect to any claim. Any Policy issued by Starr Indemnity & Liability Company will contain limitations, exclusions and termination provisions. Not all coverages available in all jurisdictions. For costs and complete details of specific policy coverage, please contact your insurance professional.

5 United Service Association For Health Care Foundation The USA+ Foundation was created over twenty years ago to help fund charities that assist those who suffer needlessly, giving them hope for the future. The USA+ Foundation receives its funding from USA+ membership dues. Each month, a portion of the dues received from each member is donated to the USA+ Foundation. We are proud to announce that the USA+ Foundation has awarded over 7 million dollars to worthwhile charities, community programs, and national research programs. The following are organizations that have received grants from the USA+ Foundation to help improve the quality of life for those facing unexpected challenges: American Diabetes Association American Red Cross Arlington Museum of Art/Arlington ISD Art Education Athletes in Action Boomer Esiason Foundation Boys & Girls Club of Greater Dallas Grand Prairie Chapter Character Counts Coalition Cook Children s Hospital Cystic Fibrosis Foundation Dallas Stars Foundation Habitat for Humanity Juvenile Diabetes Research Foundation March of Dimes Muscular Dystrophy Association Reaching America s Youth Ministries Salvation Army St. Jude Children s Research Hospital Texas Rangers Baseball Foundation United Cerebral Palsy United Way of Metropolitan Dallas Waco ISD Education Foundation Watson Children s Shelter Women s Business Support Network YMCA Tri Med Member Only $ Member / Spouse $ Member / Family $ You have 30 days from the date you receive your membership materials (or such longer period as may be required by state law) to review and evaluate the USA+ membership. If you wish to cancel your membership and receive a full refund, you may do so by submitting a written request to USA+ at the address listed below. ADMINISTRATIVE OFFICES: 1901 North Highway 360 Grand Prairie, TX USA TC_TriMed_B_ _100_MG01