ACCIDENT INSURANCE is a smart buy especially if you have kids or a HIGH DEDUCTIBLE health plan ( HDHP ) it can dovetail nicely to minimize the risk of you actually having to meet your deductible… when coupled with CRITICAL ILLNESS INSURANCE, you can create a nice wrap around your deductible to insure against 85% of most claims that would be subject to deductible & Co-Insurance. CLICK THE LINKED IMAGES BELOW & then CLICK ACCIDENT PLAN to get QUOTES for you and your family:
|VBA 24 Hour Accident Coverage|
|Accident Expense Coverage for Members and their Families|
|High Limit Options:|
|1The benefit amount shown is your accidental death benefit amount. The benefit amount for accidental dismemberment is a percentage of the accidental death amount. The benefit amount for your spouse/domestic partner is 50% of your amount and for your dependent children is 20% of your amount. If you have no dependent children, your spouse/domestic partner’s benefit amount is equal to 60% of your amount. If you have no spouse/domestic partner your dependent children’s benefit amount is equal to 25% of your amount.|
|2 The Benefit Amounts shown above for Dental, Physical Therapy, Orthopedic Appliance, and Transportation are part of, and not in addition to, the Maximum Benefit Amount for Accident Medical Expense. Payment of these Benefit Amounts reduces and does not increase the Benefit Amount for Accident Medical Expense.|
|BENEFIT DETAILS (Membership Levels $2,000, $5,000, $7,500 and $10,000)|
|ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS|
|We will pay the applicable Benefit Amount if an Accident results in a covered Loss not otherwise excluded. The Accident must result from an insured Hazard and occur while an Insured Person is insured under this policy, while it is in force. The covered Loss must occur within one (1) year after the Accident. 24 Hour Business and Pleasure Hazard means all circumstances, subject to the terms and conditions of the policy, to which an Insured Person may be exposed.|
|PRINCIPAL SUM – If Member Only coverage is selected|
|PRINCIPAL SUM – If Member + Family coverage is selected The spouse/domestic partner’s principal sum is equal to 50% of the member’s principal sum and each dependent child’s principal sum is equal to 20% of the member’s principal sum. If there are no dependent children, the spouse/domestic partner’s principal sum is equal to 60% of the member’s principal sum. If there is no spouse/ domestic partner, the dependent child’s principal sum is equal to 25% of the member’s principal sum.|
|The following are Losses insured and the corresponding Benefit Amount expressed as a percentage of the Principal Sum:|
|100% for Loss of Life, 100% for Loss of Speech and Loss of Hearing; 100% for Loss of Speech and one of Loss of Hand, Loss of Foot or Loss of Sight of One Eye; 100% for Loss of Hearing and one of Loss of Hand, Loss of Foot or Loss of Sight of One Eye; 100% for Loss of Hands (Both), Loss of Feet (Both), Loss of Sight or a combination of any two of Loss of Hand, Loss of Foot or Loss of Sight of One Eye; 50% for Loss of Hand, Loss of Foot or Loss of Sight of One Eye (Any one of each); 50% for Loss of Speech or Loss of Hearing; 25% for Loss of Thumb and Index Finger of the same hand.|
|If an Insured Person is entitled to receive payment of multiple Benefit Amounts as the result of one (1) Accident, then the maximum We will pay for all benefits shall not exceed the Principal Sum. If an Insured Person suffers multiple covered Losses as the result of one (1) Accident, then We will only pay the single largest Benefit Amount applicable to all such covered Losses.|
|Extensions of Insurance: Disappearance:If an Insured Person has not been found within one (1) year of the disappearance, stranding, sinking, or wrecking of any Conveyance in which an Insured Person was an occupant at the time of the Accident, then it will be assumed, subject to all other terms and conditions of this policy, that an Insured Person has suffered Loss of Life insured under this policy.|
|Exposure: If an Accident resulting from an insured Hazard causes an Insured Person to be unavoidably exposed to the elements and as a result of such exposure an Insured Person has a Loss, then such Loss will be insured under this policy.|
|Accident Medical Expense: This benefit will reimburse Medical Expenses up to benefit maximum if Accidental Bodily Injury causes an Insured Person to first incur Medical Expenses for care and treatment of the Accidental Bodily Injury within 90 days after an Accident. The Benefit Amount for Accident Medical Expense is payable only for Medical Expenses incurred within 52 weeks after the date of the Accident causing the Accidental Bodily Injury. The Benefit Amount is subject to a Deductible. The Deductible will be deducted from any Benefit Amount for Accident Medical Expense that We pay. This Deductible applies separately to each Insured Person and each Accident.|
|Excess Provision: The Accident Medical Expense benefit is payable on an excess basis. We will determine the Reasonable and Customary Charge for the covered Medical Expense. We will then reduce that amount by amounts already paid or payable by any Other Plan. We will pay the resulting amount less the Deductible. In no event will We pay more than the Maximum Benefit Amount for Accident Medical Expense.|
|Limitation on Accident Medical Expense|
|The Benefit Amount for Excess Accident Medical Expense does not apply to charges and services:|
|This insurance applies only to Medically Necessary charges and services.|
|Exclusions and Limitations|
|This policy does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing the insurance. In addition no benefits will be paid for any Accident caused by or resulting from any of the following:|
|Accident or Accidental means a sudden, unforeseen, and unexpected event which: 1) happens by chance; 2) arises from a source external to an Insured Person; 3) is independent of illness, disease or other bodily malfunction or medical or surgical treatment thereof; 4) occurs while the Insured Person is insured under this policy which is in force; and 5) is the direct cause of Loss.|
|Accidental Bodily Injury means bodily injury, which is 1) Accidental; 2) the direct cause of a loss; and 3) occurs while an Insured Person is insured under this policy, which is in force. This does not include conditions caused by repetitive motion injuries, or cumulative trauma not a result of an Accident, including, but not limited to: 1) Osgood-Schlatter’s Disease; 2) bursitis; 3) Chondromalacia; 4) shin splints; 5) stress fractures; 6) tendonitis; and 7) Carpal Tunnel Syndrome.|
|Benefit Amount means the amount stated which applies: 1) at the time of an Accident; 2) to an Insured Person; and 3) for an applicable Hazard.|
|Class means the categories of Insured Persons described in the policy.|
|Dependent means a Dependent Child, Spouse, or Domestic Partner of a Primary Insured Person.|
|Dependent Child means a Primary Insured Person’s unmarried child from the moment of birth, including a natural child, grandchild, stepchild or adopted child from the date of placement with a Primary Insured Person. The Dependent Child must be primarily dependent upon such Primary Insured Person for maintenance and support, and must be: 1) under the age of nineteen (19); 2) under the age of twenty-five 25) if enrolled as a full-time student at an Institution of Higher Learning; or 3) classified as an Incapacitated Dependent Child.|
|Domestic Partner means a person designated by a Primary Insured Person who is registered as a Domestic Partner under laws of the governing jurisdiction or who: 1) is at least 18 years of age and competent to enter into a contract; 2) is not related to the Primary Insured Person by blood; 3) has exclusively lived with the Primary Insured Person for at least one (1) year prior to the date of enrollment; 4) is not legally married or separated; and 5) as of the date of enrollment, has with the Primary Insured Person at least two (2) of the following financial arrangements: a) a joint mortgage or lease; b) a joint bank account; c) joint title to or ownership of a motor vehicle or status as a joint lessee on a motor vehicle lease; or d) a joint credit card account with a financial institution. Neither the Primary Insured Person nor the Domestic Partner can be married to, nor be in a civil union with anyone else.|
|Hospital means a public or private institution which: 1) is licensed in accordance with the laws of the jurisdiction where it is located; 2) is accredited by the Joint Commission on Accreditation of Hospitals; 3) operates for the reception, care and treatment of sick, ailing or injured persons as in-patients; 4) provides organized facilities for diagnosis and medical or surgical treatment; 5) provides twenty-four (24 hour) nursing care; 6) has a Physician or staff of Physicians ; and 7) is not primarily a day clinic, rest or convalescent home, assisted living facility or similar establishment and is not, other than incidentally, a place for the treatment of alcoholics or drug addicts.|
|Immediate Family Member means an Insured Person’s: 1) Spouse or Domestic Partner; 2) children including adopted children or stepchildren; 3) legal guardians or wards; 4) siblings or siblings-in-law; 5) parents or parents-in-law; 6) grandparents or grandchildren; 7) aunts or uncles; 8) nieces and nephews. Immediate Family Member also means a Spouse’s or Domestic Partner’s children, including adopted children or stepchildren; legal guardians or wards; siblings or siblings-in-law; parents or parents-in-law; grandparents or grandchildren; aunts or uncles; nieces or nephews.|
|Incapacitated Dependent Child means a child who, as a result of being mentally or physically challenged, is permanently incapable of self-support and permanently dependent on a Primary Insured Person for support and maintenance. The incapacity must have occurred while the child was: 1) under the age of nineteen (19); or 2) under the age of twenty-five (25) if enrolled as a full-time student at an Institution of Higher Learning.|
|Institution of Higher Learning means any accredited public or private college, university, professional trade or vocational school beyond the twelfth (12th) grade.|
|Insured Person means a person, qualifying as a Class member: 1) who elects insurance; or 2) for whom insurance is elected, 3) and on whose behalf premium is paid.|
|Loss means Accidental: Loss of Foot, Loss of Hand, Loss of Hearing, Loss of Life, Loss of Sight, Loss of Sight of One Eye, Loss of Speech, Loss of Thumb and Index Finger. Loss must occur within one (1) year after the Accident.|
|Loss of Foot means the complete severance of a foot through or above the ankle joint. We will consider such severance a Loss of Foot even if the foot is later reattached. If the reattachment fails and amputation becomes necessary, then We will not pay an additional Benefit Amount for such amputation.|
|Loss of Hand means complete severance, as determined by a Physician, of at least four (4) fingers at or above the metacarpal phalangeal joint on the same hand or at least three (3) fingers and the thumb on the same hand. We will consider such severance a Loss of Hand even if the hand, fingers or thumb are later reattached. If the reattachment fails and amputation becomes necessary, then We will not pay an additional Benefit Amount for such amputation.|
|Loss of Hearing means permanent, irrecoverable and total deafness, as determined by a Physician, with an auditory threshold of more than 90 decibels in each ear. The deafness cannot be corrected by any aid or device, as determined by a Physician. Loss of Life means death, including clinical death, as determined by the local governing medical authority where such death occurs within 365 days after an Accident.|
|Loss of Life means death, including clinical death, as determined by the local governing medical authority where such death occurs within 365 days after an Accident.|
|Loss of Sight means permanent loss of vision. Remaining vision must be no better than 20/200 Using a corrective aid or device, as determined by a Physician.|
|Loss of Sight of One Eye means permanent loss of vision of one eye. Remaining vision in that eye must be no better than 20/200 Using a corrective aid or device, as determined by a Physician.|
|Loss of Speech means the permanent, irrecoverable and total loss of the capability of speech without the aid of mechanical devices, as determined by a Physician.|
|Loss of Thumb and Index Finger means complete severance, through the metacarpal phalangeal joints, of the thumb and index finger of the same hand, as determined by a Physician. We will consider such severance a Loss of Thumb and Index Finger even if a thumb, an index finger or both are later reattached. If the reattachment fails and amputation becomes necessary, then We will not pay an additional Benefit Amount for such amputation.|
|Medical Expense means the Reasonable and Customary Charges for Medical Services for the care and treatment of Accidental Bodily Injuries sustained in an Accident.|
|Medically Necessary means a medical or dental service, supply or course of treatment which: 1) is ordered or prescribed by a Physician; 2) is appropriate and consistent with the patient’s diagnosis; 3) is in accord with current accepted medical or dental practice; and 4) could not be eliminated without adversely affecting the patient’s condition.|
|Medical Services means Medically Necessary services, including but not limited to: 1) medical care and treatment by a Physician; 2) Hospital room and board and Hospital care, both inpatient and outpatient; 3) drugs and medicines required and prescribed by a Physician; 4) diagnostic tests and x-rays prescribed by a Physician; 5) transportation of an Insured Person in an emergency transportation vehicle from the location where such Insured Person becomes injured to the nearest Hospital where appropriate medical treatment can be obtained; 6) dental care and treatment due to Accidental Bodily Injury; 7) physical therapy, including diathermy, ultrasonic, whirlpool or heat treatment, adjustment, manipulation, massage and the office visit associated with such therapy; 8) treatment performed by a licensed medical professional when prescribed by a Physician, if hospitalization would have been otherwise required; 9) rental of durable medical equipment; 10) artificial limbs and other prosthetic devices; 11) orthopedic appliances or braces; 12) eyeglasses, contact lenses and other vision or hearing aids.|
|Other Plan means any other insurance or payment source for Medical Services or disability, including but not limited to health coverage, disability insurance, worker’s compensation insurance; or coverage provided or required by any law or statute, including, automobile insurance “fault” or “no-fault”, employer sick leave or salary continuation plan, or similar benefit provided or required by governmental plan or program.|
|Physician means a licensed practitioner of the healing arts, acting within the scope of his or her license to the extent provided by the laws of the jurisdiction in which medical treatment is provided. Physician does not include: 1) an Insured Person; 2) an Immediate Family Member; 3) an Insured Person’s employer or business partner; or 4) the Policyholder.|
|Policyholder means Value Benefits of America, Inc.|
|Primary Insured Person means an Insured Person who: 1) has a direct relationship with the Policyholder; and 2) where applicable, elects insurance under this policy; and 3) pays the required premium, for the insurance elected.|
|Reasonable and Customary Charge means the lesser of: 1) the usual charge for a given service or supply; or 2) the charge We determine to be the prevailing charge for a given service or supply in the geographical area where it is furnished.|
|Repetitive Motion Injury means bursitis, stress fracture, strain, shin splints, Osgood Schlatter Disease, Chondromalacia, tendonitis, and Carpal Tunnel Syndrome.|
|Spouse means an Insured Person’s husband or wife or who is recognized as such by the laws of the jurisdiction in which the Primary Insured Person resides.|
|We, Us and Our FEDERAL INSURANCE COMPANY|
|VBA TERMS AND CONDITIONS|
|1. Member understands that VBA is not an insurance company or program. Accident Benefit Payments are made by the administrator for the insurance company issuing the blanket coverage to Members.2. VBA provides savings to its members on services through a number of sources. The current list of benefits may be modified through additions or deletions. A quarterly newsletter, posted on our website or sent via e-mail, will keep Members up to date on benefits and other pertinent information.
3. Payments for the VBA Program are due in advance. Payments will be drafted on or about 15 days before the due date. If you choose to cancel your program, it is your responsibility to make sure that your membership card and a written request for cancellation are sent to VBA at least 15 days prior to the anniversary of your effective date in order for your account not to be charged for additional fees.
4. Member hereby appoints, Value Benefits of America (VBA) President, or failing this person, a VBA Director, as proxy holder for and on behalf of the member with the power of substitution to attend, act and vote for and on behalf of the member in respect of all matters that may properly come before the meeting of the members of VBA and at every adjournment thereof, to the same extent and with the same powers as if the undersigned member were present at the said meeting, or any adjournment thereof. Annual meetings are to be held in Arizona the second Tuesday of August.
5. VBA reserves the right to terminate any enrollment or deny eligibility in the program for lack of payment to VBA. Returned checks, insufficient notices on bank drafts or denial by the member’s credit card company for payment of the membership fee is deemed to be evidence of non-payment by a member. There will be a $10.00 charge to be reinstated in the program after such denial. If reinstatement for non-payment happens more than once, a $20.00 reinstatement will apply.
6. In the event of any dispute, member agrees to resolve said dispute solely by binding arbitration that shall be governed by the laws of the state of Arizona and enforceable at Scottsdale, Maricopa County.
7. Membership cancelled within the first 30 days of the enrollment date may be eligible for refund if the membership card and written cancellation request are sent to VBA. The administrative fee is not refundable. Approved refunds will be processed approximately 30 days after cancellation.
8. Membership is effective on the 1st of the month following enrollment acceptance by VBA.
|Discounts and Dividends are not insurance|
|SECURITY & PRIVACY STATEMENT|
|When you become a GACquote.com customer, you entrust us with your personal data. We consider your data to be private and confidential, and we hold ourselves to the highest standards of trust and fiduciary duty in their safekeeping and use.General Agent Center (GAC) and our partners will not release information about you or your application, policy or claims information, unless one or more of the following conditions are met:
Questions about your medical history and physical condition are required by our insurance carrier partners and will be released to the insurer so that they may underwrite your insurance application. GAC will not give or sell information about you to any other company, individual, or group without your prior authorization.
GAC will only use information about you to help us better serve your insurance needs or to suggest GAC services or insurance materials that may be of interest to you.
To further protect your privacy, our web site uses the highest levels of Internet security, including data encryption, user names and passwords, and other security tools.
Occasionally, GAC may conduct marketing surveys or research to help us evaluate products, services, and the changing needs of our customers. It is GAC’s policy to keep this information confidential.
We will not share individual marketing data gathered from our web site with individuals or business entities not affiliated with GAC.
We know that the privacy of your personal information is important to you. In order to provide you with insurance products of the highest quality and with the service you deserve, it may be necessary for us from time to time to collect nonpublic personal and financial information about you (the “Information”) and, in certain situations, to share that Information with others. The following notice describes our policies and practices with regard to your Information.
|HOW WE PROTECT YOUR INFORMATION|
|We maintain physical, electronic and procedural safeguards to protect the Information against unauthorized access and use. We restrict access to the Information to those employees who need access to provide products and services to you and your dependents. The personnel who have access are trained in the proper handling of the Information. Employees who violate this strict level of confidentiality are subject to our disciplinary process.|
|CATEGORIES OF INFORMATION THAT WE COLLECT|
|In the normal course of business we may collect the following types of Information:
|HOW WE USE YOUR INFORMATION|
|ACCURACY OF YOUR INFORMATION|
|We strive to maintain the accuracy of Information that is in our possession about you. In order to help us maintain accuracy, you have the right to reasonably access your information. If you believe any information in our possession is inaccurate, a request can be made to amend or delete the information that you believe to be erroneous. If we concur with the request, we will amend or delete the information in question. You may write our Privacy Office at the address below to receive our complete policy on accessing and amending the Information.|
|CHANGES TO THIS NOTICE|
|We reserve the right to change this Notice. We reserve the right to make the revised Notice effective for the Information we already have about you as well as any Information we receive in the future. If we make any material changes to our policies or practices, we will provide you with a copy of a revised Notice. We will post a copy of the current Notice on our websites. The Notice will contain in the top right-hand corner, the effective date.|
|You may contact our Privacy Office at:|
|General Agent Center
15575 North 79th Place, Suite 100 Scottsdale, AZ 85260