Accident Insurance

Cost and coverage

The University offers 2 plan options to choose from with employee and dependent coverage options.

PLAN COST	EE	EE + Sp	EE + CH	F
Plan 1 monthly cost	$17.99	$33.86	$36.84	$44.89
Plan 2 monthly cost	$24.67	$47.22	$51.68	$63.45

Services covered

This plan pays benefits for accident-related services based on a set schedule. See plan brochure for additional details. Covered spouses get 50% of the amount shown in the injury benefit schedule and children receive 25%.

• Plan 1 includes benefits up to $4000 for complete dislocation/fracture, $40,000 accidental death and dismemberment, and an outpatient physician’s treatment visit of $50.
• Plan 2 includes benefit up to $6000 for complete dislocation/Fracture, $60,000 accidental death and dismemberment, and an outpatient physician’s treatment visit of $75.

How to use the benefit

You may file a claim using the attached claim form, or by calling 877-282-0808 for assistance.  Funds received are payable directly to you and can be used to offset medical cost or for normal household expenses.

Enrolling and changing

This is a voluntary addition to your other insurance and should not be considered as a replacement for health insurance.

Accident insurance has guaranteed issue and maybe enrolled at any time. Covered services must be incurred after effective date and pre-existing limitations may apply.

For more information, contact human resources.

Forms and publications

Forms

• Out patient Physician treatment Claim form
• Accident Claim Form
• Attending Physician Statement

Publications

• Brochure
• Accident SPD

Policy

• G7.02-6.1.7 Voluntary Benefits