Accident Recovery
Live life to the fullest...
Protect yourself against the unexpected.
WHY?
Accident
Recovery
Who can enroll?
You are eligible to enroll
through your employer if you
work more than 20 hours per
week, are actively at work, and
are under age 65. Coverage is
offered for you, your spouse
and any eligible dependents.
110 million
The number of
emergency room visits
annually.1
122 thousand
The approximate number
of annual deaths due to
accidents.2
90 percent
The percentage of disabling
accidents and illnesses are
not work related and thus
not covered by workers’
compensation.3
You want to live your life to the fullest
doing the things with your family and friends that
bring you pleasure and fulfillment. You should.
But please make sure that you are financially
prepared against the unexpected accidents
which can occur at the most inconvenient times.
As healthcare costs rise, your medical plan
deductibles increase right along with them. It is
a good idea to carry a little extra protection –
like a plan that pays YOU if you or one of your
covered dependents has an accident.
ACCIDENT TREATMENT
BASIC
SELECT
ULTRA
Physician Office Visit
$125/2 visits
$150/2 visits
$225/2 visits
Emergency Treatment
$125
$150
$225
Emergency Dental (crown/extraction)
$250/$100
$300/$120
$450/$180
Major Diagnostic Exam
$200
$240
$360
Lacerations
$400
$480
$720
Burns (based on severity)
$500/$2,500
$600/$3,000
$900/$4,500
Eye Injury (surgical & non-surgical repair)
$200/$35
$240/$42
$360/$63
Brain Injury
$500
$600
$900
Hip (Open/Closed)
$2,750/$750
$3,300/$900
$4,950/$1,350
Knee or Shoulder (Open/Closed)
$600/$250
$720/$300
$1,080/$450
Toe or Finger (Open/Closed)
$125/$60
$150/$72
$225/$108
Hip (Open/Closed)
$2,750/$1,375
$3,300/$1,650
$4,950/$2,475
Leg (Open/Closed)
$1,200/$625
$1,440/$750
$2,160/$1,125
Nose, Heel or Finger(s) (Open/Closed)
$600/$150
$720/$180
$1,080/$270
BASIC
SELECT
ULTRA
Physician Follow-up
$50/ 6 visits
$70/ 6 visits
$80/ 6 visits
Rehabilitation Unit
$125/30 Days
$175/30 Days
$200/30 Days
Physical Therapy
$100/ 6 visits
$140/ 6 visits
$160/ 6 visits
Appliance (for Locomotion)
$100
$140
$160
Prosthetic Device (One device/two or more devices)
$375/$750
$525/$1,050
$600/$1,200
Family Lodging (for non-local Hospital Confinement)
$100/30 Days
$150/30 Days
$175/30 Days
Transportation (for non-local Treatment)
$400/3 Trips
$600/3 Trips
$700/3 Trips
Post Transportation
$200
$300
$350
Dislocations (examples)
Fractures (examples)
FOLLOW-UP CARE
SURGERY
BASIC
SELECT
ULTRA
Tendon/Ligament
$500
$600
$800
Torn Knee (Surgical repair/Exploratory)
$500/$375
$600/$450
$800/$600
Ruptured Disc
$500
$600
$800
Torn Rotator Cuff
$500
$600
$800
Wellness (payable once per calendar year for each
covered person)
$60
$75
$105
Highlights of Plan
• This plan provides coverage 24 hours a day – no matter where your accident occurs.
• There is no deductible, annual maximum, or limit to the number of accidents you can have.
• This coverage is portable which means you can take your plan with you if you choose to leave your place of employment.
• Your employer has agreed to payroll deduct your premium, so you are sure to maintain your coverage.
• This plan pays YOU in the event of an accident. It does not coordinate with other insurance you may have.
• You can enroll just yourself or you can also enroll your spouse and dependent children.
HOSPITAL CARE
BASIC
SELECT
ULTRA
Wellness Benefit
Initial Hospitalization
$1,000
$1,200
$1,600
Covered persons can receive an annual
Hospital Confinement (per day up to 365 days)
$250
$250
$250
payment of $60 with the BASIC plan, $75
Hospital ICU (per day up to 15 days)
$500
$500
$500
with the SELECT plan and $105 with the
Surgery (Reparation of internal injuries/exploratory)
$1,250/$250
$1,500/$300
$2,000/$400
ULTRA plan when they undergo a health
Ambulance (Air/Ground)
$1,250/$200
$1,500/$240
$2,000/$320
screening test such as Mammogram, Pap
Blood, Plasma, Platelets
$200
$240
$320
Test, PSA (Prostate-Specific Antigen Tests)
and Colonoscopy.
Should you buy?
There are a lot of good ways to spend your money. Before you decide, review the statements below. Check if the
statement is true for you, your spouse, or your children.
Me
My spouse My kids
We like to do home fix-up projects ourselves.
We are active in sports.
We travel in our car frequently.
We like to exercise regularly or plan to soon.
Fall and spring clean-ups find us up on high ladders.
Although there is no magic number, if you checked one or more boxes, you or someone in your family is at risk to have an accident.
So,
how
Employee chooses
the Accident Select
plan coverage
?
does it work
Employee has
their annual
wellness exam
+
injury
occurs
In addition to what their major medical insurance
paid, our Accident Select coverage paid for:
Wellness
Ambulance Service
$240
Emergency Room Treatment
$150
Fractured Elbow (Open)
$720
Surgery
Later in the year, the
employee falls off a ladder
and fractures their elbow
$75
$1,500
2 Follow-Up Physician Visits
$140
6 Physical Therapy Sessions
$840
=
$
Total Cash Benefits
Paid Directly
to Employee
$3,665
Top 5
Leading Causes of Nonfatal Injuries Treated in Hospital
Emergency Departments in 2010 across all ages.
•
•
•
Falls
Struck by or against something
Overexertion
•
•
•
Motor vehicle accident
Accidental cut or puncture wound
For children 5 to 14 – bike riding is #5.
Source: NEISS All Injury Program operation by the Consumer Product Safety Commission (CPSC).
Optional Rider - Accidental Death & Dismemberment
(Employer chooses from the following):
OPTIONAL RIDER 1
INSURED
SPOUSE
CHILD
Common Carrier Accidental Death
$75,000
$75,000
$18,750
Other Accidental Death
$50,000
$50,000
$6,250
INSURED
SPOUSE
CHILD
Common Carrier Accidental Death
$150,000
$150,000
$37,500
Other Accidental Death
$100,000
$100,000
$12,500
OPTIONAL RIDER 2
This rider also provides • Accidental Dismemberment
• Paralysis
benefits for:
• Coma
• Repatriation
• Child Education
• Child Care Center
• Spouse Training
Your selections:
Employee only
Employee + Spouse
Employee + Child(ren)
Family
Plan:
Basic
Premium: $____________
Select
per pay period
Ultra
per month
This brochure provides a very brief description of USAble Life’s Accident Recovery product.
This is not an insurance policy and only the actual provisions of an issued policy will control.
USAble Life’s policies set forth the rights and obligations of covered persons and USAble Life.
Please be aware that certain limitations and exclusions apply and coverage may reduce or
terminate due to age or lack of eligibility. If employees enroll for coverage, the employer will
be furnished with a policy or certificate of insurance for distribution to covered employees.
Please read your insurance documents carefully. Policy number: GA-P (5-12)
1
• Additional benefits if
a seat belt was worn or
airbag deployed at time
of accidental death
What else do you need to know?
Coverage for: This is a brochure which is just a brief description of the coverage offered. It is
not a contract. Like all insurance products, there are certain terms, conditions,
limitations and exclusions contained in the policy to which this plan is subject.
The benefits of this plan may be subject to pre-existing conditions limitations
or waiting periods. Specifically the plan does not cover injuries from high risk
activities. This information includes some examples of activities that would not be
covered if you were injured. You can receive the full list from USAble Life.
This plan does not cover hospitalizations incurred due to exposure to any act of
war, riot or insurrection or if the covered person is serving in the armed forces.
Self-inflicted injuries or injuries sustained while participating in illegal activity
are not covered, neither are injuries from any kind of non-commercial air flight.
Injuries from auto accidents when driving while under the influence of alcohol or
narcotics are not covered.
Any injury suffered while participating in an extreme sport such as bungee
jumping, sail gliding, parasailing or skydiving is not covered. Similarly, any kind
of stunt driving or speed racing injury is not covered. If you are injured while
participating in a sport as a professional or semi-professional athlete, no benefits
are paid.
American Academy of Urgent Care Medicine
The basics of accidental death and dismemberment insurance by Insure.com, 2010
3
National Safety Council, Injury Facts 2008 Edition
2
PO Box 1650 • Little Rock, AR 72203 • (800) 370-5856 • (501) 375-7200 • www.usablelife.com
USAL-ECR-ACC-BR (8-13)
Your Employer Chose: