Accident Insurance

Accident Insurance pays you benefits for specific injuries and events resulting from a covered accident. The amount of benefit depends on the type of injury and the care received. The Accident Insurance Plan pays benefits for accident-related hospital care, follow-up care, common injuries, and emergency care. Accident Insurance is not health coverage, like a medical plan, but is a limited benefit policy that supplements your health coverage.

In addition to accident-specific benefits, the plan also provides an annual wellness benefit if you receive a covered health screening.

The accident insurance plan is administered by Voya.

Accident Insurance Benefits

The plan defines an accident as an unforeseen event that results in bodily injury. For the benefits described below, an accident is covered if it:

Occurs on or after your coverage effective date and the effective date of any riders,
Occurs while your coverage is active, and
Is not specifically excluded.

EVENT	BENEFIT
Accident hospital care
Surgery open abdominal, thoracic	$2,500
Surgery exploratory or without repair	$350
Blood, plasma, platelets	$650
Hospital admission	$2,000
Hospital confinement per day, up to 365 days	$350
Critical care unit confinement per day, up to 15 days	$700
Rehabilitation facility confinement per day, up to 90 days	$225
Coma duration of 14 or more days	$11,500
Transportation per trip, up to 3 per accident	$840
Lodging per day, up to 30 days	$220
Accident care
Initial doctor visit	$120
Urgent care facility treatment	$300
Emergency room treatment	$300
Ground ambulance	$300
Air ambulance	$2,500
Follow up doctor treatment	$120
Medical equipment	$500
Physical or occupational therapy per treatment, up to 6	$75
Speech therapy per treatment, up to 6	$75
Prosthetic device (1)	$1,500
Prosthetic device (2 or more)	$2,400
Major diagnostic exams CT or CAT scan, MRI, EEG, or PET scan	$500
Outpatient surgery per procedure	$300
X-ray	$100
Common injuries
Burns second degree, at least 36% of the body	$1,750
Burns 3rd degree, at least 9 but less than 35 square inches of the body	$10,000
Burns 3rd degree, 35 or more square inches of the body	$22,000
Skin grafts	50% of burn benefit
Emergency dental work while hospital confined	$480 crown, $180 extraction
Eye injury removal of foreign object	$120
Eye injury surgery	$420
Torn knee cartilage surgery with no repair or if cartilage is shaved	$280
Torn knee cartilage surgical repair	$1,000
Ruptured disk surgical repair	$1,000
Tendon/ligament/rotator cuff 1, surgical repair	$1,020
Tendon/ligament/rotator cuff 2 or more, surgical repair	$1,520
Tendon/ligament/rotator cuff exploratory arthroscopic surgery with no repair	$720
Concussion	$450
Paralysis quadriplegia	$30,000
Paralysis paraplegia	$20,000
Lacerations
Laceration benefits are a total of all lacerations per accident.
Laceration treated no sutures	$60
Laceration sutures up to 2”	$120
Laceration sutures 2” – 6”	$480
Laceration sutures over 6”	$960
Dislocations	Closed reduction	Open reduction
Closed Reduction of Dislocation = Non-surgical reduction of a completely separated joint. Open Reduction of Dislocation = Surgical reduction of a completely separated joint.
Hip joint	$3,200	$6,400
Knee	$2,000	$4,000
Ankle or foot bone(s) other than toes	$1,200	$2,400
Shoulder	$1,500	$3,000
Elbow	$900	$1,800
Wrist	$900	$1,800
Finger/toe	$250	$500
Hand bone(s) other than fingers	$500	$1,000
Lower jaw	$900	$1,800
Collarbone	$900	$1,800
Partial dislocations	25% of the closed reduction amount
Fractures	Closed reduction	Open reduction
Closed Reduction of Fracture = Non-surgical. Open Reduction of Fracture = Surgical.
Hip	$3,000	$6,000
Leg	$2,500	$5,000
Ankle	$1,200	$2,400
Kneecap	$1,200	$2,400
Foot excluding toes, heel	$1,200	$2,400
Upper arm	$1,400	$2,800
Forearm, hand, wrist except fingers	$1,200	$2,400
Finger, toe	$160	$320
Vertebral body	$2,240	$4,480
Vertebral processes	$960	$1,920
Pelvis except coccyx	$2,250	$4,500
Coccyx	$400	$800
Bones of face except nose	$800	$1,600
Nose	$400	$800
Upper jaw	$1,000	$2,000
Lower jaw	$960	$1,920
Collarbone	$960	$1,920
Rib or ribs	$500	$1,000
Skull – simple except bones of face	$1,750	$3,500
Skull – depressed except bones of face	$5,000	$10,000
Sternum	$700	$1,400
Shoulder blade	$1,200	$2,400
Chip fractures	25% of the closed reduction amount
Additional benefits
Sports accident benefit	25% of the accident hospital care, accident care, or common injuries benefit listed above, up to a maximum benefit of $1,000

Accident Insurance Wellness Benefit

The plan provides the following annual benefit if you complete a health screening test:

You: $75
Your spouse/domestic partner: $75
Your eligible child: 100% of your amount

This wellness benefit is payable once per year. If you receive multiple health screenings, you will only receive one benefit from this plan.

Screenings include, but aren't limited to:

Blood test for triglycerides
Flexible sigmoidoscopy
Bone marrow testing
Hemoccult stool analysis
Breast ultrasound, sonogram, MRI
Mammography
CA 15-3 (breast cancer)
Fasting blood glucose test
PSA (prostate cancer)
Pap smear or thin prep pap test
CEA (blood test for colon cancer)
Serum cholesterol test for HDL & LDL levels
Serum Protein Electrophoresis (myeloma)
Chest x-ray
Colonoscopy
Stress test on bicycle or treadmill
Thermography
Any generally medically accepted cancer screening test
Electrocardiogram (EKG)
Routine eye exam
Well child/preventive exams through 18
Biometric screenings