Why do I need accidental death and dismemberment insurance?
Consider what would happen if you died as a result of an accident. Accidental death and dismemberment coverage helps provide your family financial relief if you are involved in an accident that results in death or dismemberment. Even with an employer-sponsored life insurance plan, oftentimes, you may need more coverage if you should lose your life in an accident. This plan provides additional coverage to what you may already have at a very reasonable cost.
How is accidental death and dismemberment coverage different from life insurance?
While life insurance typically provides benefits to an individual's family no matter how a death occurs, accidental death and dismemberment coverage provides benefits to victims and their family only in the case of an accident - for example, a car accident or a work accident. It does not provide benefits, for instance, for individuals who die naturally or due to an illness.
And unlike life insurance, accidental death and dismemberment coverage provides benefits if the insured loses a limb, speech, hearing or sight from an accident. One of the real values of accidental death and dismemberment insurance comes from its low cost for high coverage amounts.
What is a "covered accident"?
A covered accident is an accident that occurs while the person is covered under the policy and which has an Injury and Loss as a direct result (independent of all other causes). Loss resulting from: a) sickness or disease, except a pus-forming infection which occurs through an accidental wound; or b) medical or surgical treatment of a sickness or disease, is not considered as resulting from Injury.
What does "base benefit amount" mean?
"Base benefit amount" is the amount you want your beneficiaries to receive in case of accidental death. It is called "base benefit amount" because, depending on the type of accident, your beneficiaries could receive additional benefits.
- Example 1: If an accidental death results from a motor vehicle accident or as a pedestrian, your beneficiary would receive the base benefit amount plus $25,000. If you purchased a base benefit amount of $100,000 of Enhanced coverage, your beneficiary would receive $130,000 ($100,000 base benefit amount + $25,000 for motor vehicle accidental death + $5,000 no-cost coverage).
- Example 2: If an accidental death occurs due to injury sustained while riding as a passenger on any common carrier - such as an airplane, train, bus or taxi - your beneficiary would receive the base benefit amount plus $100,000. If you purchased a base benefit amount of $100,000 of Enhanced coverage, your beneficiary would receive $201,000 ($100,000 base benefit amount +$100,000 for common carrier accidental death + $1,000 of no-cost coverage).
What does "common carrier" mean?
Common carrier refers to any mode of transportation operated by a business, other than the Policyholder, organized and licensed for the transportation of passengers for hire and operated by an employee of that business.
What does "injury" mean?
Injury means bodily injury resulting directly from an accident and independent of all other causes. Loss resulting from sickenss or disease, or medical or surgical treatment of a sickness or disease is, not covered. The accident must occur while you are covered under the policy.
How much insurance do I need?
The amount of insurance you need depends on your personal situation, including marital status, number of children, etc. Use one of Union Plus' online needs calculators to help determine what the right amount of insurance may be for you. You may wish to consult a personal financial advisor.
What makes Union Plus different?
Union Plus exclusively serves the needs of union members and their families by providing group insurance at specially negotiated rates. Unlike many other plans, the Union Plus plan offers:
- Inflation guard - your base benefit amount increases automatically to help keep your benefit amount in line with the increasing cost of living. This benefit increases for a maximum of 10 years, up to 125% of the Principle Sum.
- Waiver of premium payment - you may not have to pay your premium for up to one year during a union-sanctioned strike or lockout lasting 30 days or more. May not be available for all unions or in all states.
- Coverage for members ages 18 and over - the Union Plus plan covers you as long as you remain a U.S. resident, pay your premiums and the master policy remains in force. Coverage for your eligible dependents remains in effect until your coverage ends or they no longer qualify as eligible dependents.
Is the $5,000 no-cost coverage different from the Enhanced coverage?
Yes. The no-cost coverage provides the beneficiary $5,000 in the event of death from a motor vehicle accident or $1,000 from any other covered accidental cause. This no-cost coverage is available to union members only.
The Enhanced coverage pays additional benefits. It pays up to $200,000 base benefit amount for loss of life due to accidental injury with automatic additional extra benefits. Coverage for the loss of a limb, speech, hearing or sight ranges from 100% to 25% of the base benefit amount, depending on the type of loss. Enhanced coverage offers optional coverage for family members, which includes spouse or domestic partner and children.
What does the Enhanced coverage insure for?
Enhanced coverage provides:
- Larger base benefit amounts - $25,000 to $200,000
- Coverage for family members - spouse/domestic partner and children
- Additional extra benefits:
- An additional $100,000 for accidental death while riding as a passenger on any common carrier, such as, an airplane, train, bus or taxi.
- An additional $50,000 for workplace accidental death.
- An additional $25,000 for accidental death resulting from a motor vehicle accident or as a pedestrian.
- Inflation guard - your base benefit amount increases automatically to help keep your benefit amount in line with the increasing cost of living. This benefit increases for a maximum of 10 years, up to 125% of the Principle Sum.
- Strike waiver of premium - premium will be waived for up to one year during a union-sanctioned strike or lockout lasting 30 days or more. May not be available for all unions or in all states.
What is the "inflation guard"?
The inflation guard or anti-inflation benefit is applicable only to the Enhanced Accidental Death and Dismemberment benefit, not the no-cost coverage. If you sustain an injury which results in death and a Principal Sum (base benefit amount) is payable under the Accidental Death and Dismemberment Benefit, we will pay an inflation adjustment in addition to the Principal Sum.
The anti-inflation benefit will be the amount of your Principal Sum, at the time of the claim, multiplied by 2.5% for every year of continuous coverage you have been covered under the Policy (to a maximum of 10 years and subject to a maximum of 25%).
If you purchase additional coverage, the anti-inflation benefit will be applied separately to your Principal Sum for each additional amount applied for. If coverage is reduced, any anti-inflation benefit which was increased will be reduced proportionately. The amount of the Principal Sum is indicated in Your Schedule.
For example, in 2009, you enroll in $5,000 no-cost coverage and purchase an additional $100,000 in Enhanced coverage, the Principal Sum. In 2013, you are involved in a motor vehicle accident that results in death, so the anti-inflation benefit will be calculated as follows: 2.5% x $100,000 (Principal Sum) x 4 years of continuous coverage = $10,000. At the time the claim was paid, your beneficiary would receive $140,000 (the Principal Sum $100,000 + the anti-inflation benefit $10,000 + $25,000 additional benefit for motor vehicle death + $5,000 no-cost coverage).
Does the no-cost coverage pay in addition to the Enhanced coverage?
Yes, if you are enrolled in the no-cost coverage and the Enhanced coverage at the time of the fatal accident, the beneficiary will receive benefits from both coverages.
Is family coverage available?
Yes, but only when you purchase the enhanced coverage. The family plan option covers the spouse/domestic partner and children for a small additional charge. The "no-cost coverage" is for union members only.
Can my spouse and children receive the same coverage amount as me, the union member?
If you purchase Family Coverage, spouse/domestic partner benefit is 50% of the insured's benefit, and each child is covered for 10% of the insured's benefit.
What is the policy review period?
Members have 60 days to review the Certificate of Insurance. If you change your mind within that time you are entitled to a full refund of premium, less any claim paid during the first 60 days.
When does coverage become effective?
For the no-cost benefit, the coverage is effective the first day of the month following receipt of the enrollment form. This date appears on the certificate you will receive by mail. For the enhanced coverage, coverage is effective the first day of the month following receipt of the enrollment form and payment of the premium.
What happens when an insured is involved in an accident but death doesn't occur right away?
The benefit will be paid if death occurs as a result of the accident within 365 days of the accident.
Are newborn and adopted children covered?
Yes, they are automatically covered as dependents for 31 days after birth or adoption. After 31 days coverage continues once you notify the insurer and the premiums are paid - or automatically if you have already purchased family coverage.
Can domestic partners be covered?
Yes. Domestic Partner means the Eligible Person's Domestic Partner of the same or opposite sex who: a) is mentally competent and is at least 18 years of age; b) is not a blood relative any closer than would prohibit legal marriage; c) has shared the Eligible Person's permanent residence or has resided with the Eligible person for more than 6 months; d) shares joint responsibility with the Eligible Person which is evidenced to us by submission of proof of at least two of the following: 1) common ownership of real property or a common leasehold interest in such property; 2) common ownership of a motor vehicle; 3) joint bank accounts or credit accounts; 4) designation as a beneficiary for life insurance or retirement benefits, or under the partner's will; 5) assignment of a durable Power of Attorney or Health Proxy to one another; or 6) any other proof that would be sufficient to us to establish economic dependence on one another; and e) has signed a notarized affidavit, acceptable to us, with the Eligible Person. A Domestic Partner does not qualify as a Domestic Partner under this policy if he or she: a) has signed a Domestic Partner affidavit or declaration with any other person within 12 months prior to designating a Domestic Partner under this policy; b) is currently legally married to another person; or c) has any other Domestic Partner, Spouse or Spouse equivalent of the same or opposite sex.
If the primary insured dies, can a spouse or domestic partner continue coverage?
Yes.
Can children be covered if the union member is divorced?
Yes, children can be covered even if the insured doesn't have custody, as long as the children are primarily dependent on the union member for support and maintenance.
Will the benefits within the policy ever change?
Yes, benefits reduce in half when you reach age 70. Premiums will remain the same.
Why do benefits reduce at age 70?
In order to provide reasonable rates for the largest number of union members, it is necessary to either reduce coverage or increase premiums for certain groups.
Does this coverage pay if an insured is hospitalized for an accident?
No, this coverage pays only for accidental death or dismemberment, not for hospital cost.
What exactly does dismemberment mean?
For purposes of this policy, it means the loss of either one or both hands, thumb or index finger on either hand, feet, arms or legs, eyes, speech or hearing. Dismemberment benefits are a percentage of the base benefit amount, depending on the Loss.
| |
Insured Person |
Insured Person |
Covered Spouse |
Covered
Spouse |
Covered |
| |
Under age 70 |
age 70 and Over |
Under age 70 |
age 70 and Over |
Child |
| Life |
100%
|
50%
|
50%
|
25%
|
10%
|
| Both Hands or Both Feet or Sight of Both Eyes |
100%
|
50%
|
50%
|
25%
|
10%
|
| One Hand and One Foot |
100%
|
50%
|
50%
|
25%
|
10%
|
| Speech and Hearing |
100%
|
50%
|
50%
|
25%
|
10%
|
| Either Hand or Foot and Sight of One Eye |
100%
|
50%
|
50%
|
25%
|
10%
|
| Either Hand or Foot |
50%
|
25%
|
25%
|
12.5%
|
5%
|
| Sight of One Eye |
50%
|
25%
|
25%
|
12.5%
|
5%
|
| Speech or Hearing |
50%
|
25%
|
25%
|
12.5%
|
5%
|
| Thumb and Index Finger of Either Hand |
25%
|
12.5%
|
12.5%
|
6.25%
|
5%
|
What does "loss" mean?
Loss means, with regards to hands and feet, actual severance through or above wrist or ankle joints; with regard to sight, speech or hearing, entire and irrecoverable loss thereof; with regard to thumb and index finger, actual severance through or above the metacapophalangeal joints.
What if death occurs from cancer or other catastrophic illness?
The coverage pays only for death due to accidents. It does not pay for death by natural causes such as cancer, old age, sickness or disease.
What does the Strike/Labor Dispute Waiver of Premium mean?
If an insured is in a lawful, authorized strike by a union or is locked out as a result of a dispute between the union and employer, the insured doesn't have to pay premiums on this coverage for up to one year. Waiver may not be available in all states or for all unions.
How does the Strike/Labor Dispute Waiver of Premium work?
Premiums will be waived beginning with the first premium due date following a strike or lock out. Premium payments will be waived for up to one year, but will resume on the earliest of the following:
- One year from when the strike or lockout began.
- The next premium due date after resolution.
- Next premium due date after return-to-work offer, or
- Next premium due date after employment is terminated.
What is the process for getting the premium waived?
The insured must provide written proof of strike or lock out before wavier of premium begins. It can be a note from the union or a note from the insured with a newspaper article, verifying the sanctioned strike or lock out.