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Group Accident Insurance Coverage

For eligible employees of the Montana University System

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$25,000 to $300,000 in sensible and affordable accidental death and dismemberment benefits.

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Accidents aren't supposed to happen, but they do. A collision on the highway . . . a fall in the home . . . an accident while traveling, these, and other unpredictable occurrences, pose a constant threat to your future earning ability and financial security. That's why we are giving employees an opportunity to increase their overall insurance protection with affordable, high-limit accidental death and dismemberment benefits that cover you 24 hours a day, on or off the job, at a price you can afford.

Available to eligible employees, acceptance guaranteed.
All active, full-time employees are eligible. You cannot be refused acceptance for any reason!

Benefits to suit your needs . . . $25,000 to $300,000.
Regardless of how much other coverage you have, you are free to select your own benefit in multiples of $25,000 up to the maximum amount. If you choose more than $150,000 of coverage, your benefit amount must not be more than ten times your annual salary. Your benefit amount will be a percentage of your selected benefit depending on your age on the date of loss:

EXAMPLE:
If you enrolled in the plan at age 55 and selected a benefit amount of $100,000, your selected benefit amount would reduce to $65,000, if loss occurred at age 70.

Your choice of individual or family coverage.

When you enroll, your eligible family members are guaranteed acceptance, too. Your spouse and all unmarried, dependent children under age 19, (or under 25 if attending school full-time) can be insured for a portion of your benefit amount for a small additional monthly cost.

A person may not be insured as both an employee and a dependent. An eligible dependent child may not be insured as a dependent child of more than one employee.

An insured spouse is covered for (1) 60% of the Insured Employee's Principal Sum if there are no insured dependent children at the time of the accident or (2) 50% of the Insured Employee's Principal Sum if there are insured dependent children at the time of the accident.

Each insured dependent child is covered for (1) 20% of the Insured Employee's Principal Sum for Loss of Life Benefit and 50% of the Insured Employee's Principal Sum for determining dismemberment benefits if there is no insured spouse at the time of the accident or (2) 15% of the Insured Employee's Principal Sum for Loss of Life Benefit and 50% of the Insured Employee's Principal Sum for determining dismemberment benefits if there is an insured spouse at the time of the accident.

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Here's how benefits pay up to
$300,000 in protection

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Accidental death benefits.

If you die as a result of a covered accident within 365 days of its occurrence, your Group Accident Coverage will pay your beneficiary your full benefit amount.

Accidental dismemberment benefits.

Benefits will be paid for specific losses caused by a covered accident within 365 days of its occurrence, as below.

The entire benefit amount will be paid for: loss of both hands or both feet, complete loss of sight in both eyes.

One-half the benefit amount will be paid for: loss of one hand or one foot, complete loss of sight in one eye, loss of speech, or loss of hearing in both ears.

One-fourth the benefit amount will be paid for: loss of thumb and index finger on same hand.

For Accidental dismemberment benefits, loss of hand or foot means complete severance through or above the wrist or ankle joint. Loss of sight means irrecoverable loss of vision. Loss of speech and hearing must be irrecoverable. Fingers must be completely and permanently severed through or above the third joints.

A benefit is not payable for both loss of thumb and index finger on same hand, and loss of one hand, for injury to the same hand as a result of any one accident.

In no event will benefits payable under this provision due to the same accident exceed the applicable Principal Sum.

Paralysis Benefit.
If, because of a covered injury to the spinal cord or brain and beginning within 365 days after the date of the accident, you sustain Hemiplegia, Paraplegia or Quadriplegia, we will pay 1% of the stated percentage of your benefit amount shown in the Schedule below. This benefit is payable on a monthly basis beginning with the 13th month of such paralysis for a maximum of 100 successive months provided such paralysis continues. However, the maximum benefit payable will not exceed the benefit amount for the insured person whose injury is the basis for the claim.

Schedule

If the insured person dies during a period for which benefits are payable and before an amount equal to the benefit amount has been paid, the remaining unpaid benefit will be paid in one lump sum to the beneficiary. In no event will the Paralysis Benefit plus any Accidental Death or Dismemberment Benefit exceed the insured person's benefit amount because of the same accident.

Paralysis must be determined by competent medical authority to be permanent, complete and irreversible.

Common Disaster Benefit.
If while covered under the family plan, you and your insured spouse both suffer loss of life due to covered injuries caused by the same accident or separate accidents which occur within 24 hours of each other, we will increase the Principal Sum for your insured spouse to equal yours, provided you both suffer loss of life within 90 days of the accident.

Spouse Retraining Benefit.
If loss of life benefits are payable as the result of a covered injury to you, and your eligible family members are covered under the policy on the date of the accident, we will pay a Spouse Retraining Benefit for your spouse, who, on the date of the accident, was not employed in an income producing occupation and, as a result of the accident, must seek employment on a full-time basis. This benefit is payable provided your spouse is enrolled as a full-time student for the purpose of preparing for employment, within one year after your death in:

The Spouse Retraining Benefit will be payable one time in an amount equal to 5% of your benefit amount or $5,000, whichever is less. It will be paid to your spouse immediately upon our receipt of satisfactory proof that the above requirements have been met.

If there is no spouse who qualifies under A or B above, we will pay in one Lump Sum $3,000 to the Insured's beneficiary.

"School for Higher Learning", means an educational institution above the 12th grade level. It includes, but is not limited to, any state university, junior college or trade-vocational school.

Extended Dependent Coverage
Upon receipt of due written proof of your death while your coverage is in force, we will waive the payment of any premium becoming due for your insured family members until the earliest of the following dates at which time all insurance shall terminate:

Special Education Benefit
If you have selected the Family Plan coverage and then lose your life or Permanent Total Disability benefits are payable as the result of a covered accident, the Insurance Company will pay in addition to all other benefits, 5% of your Benefit Amount or $5,000 whichever is lesser, to any insured dependent child who, on the date of the accident, was enrolled as a full-time student in any institution of higher learning beyond the 12th grade level or, was at the 12th grade level and subsequently enrolls as a full-time student in an institution of higher learning within 365 days following the accident.

The benefit is payable annually for a maximum of four consecutive annual payments but only if the dependent child continues his or her education, as a full-time student in an institution of higher learning.

If you have selected the Family Plan coverage but do not have any dependent children or your dependent children do not qualify for this benefit, a one time payment equal to $3,000 will be paid to your beneficiary.

Safe Driving Benefit.
Your benefit amount will be increased by 10% of the employee's benefit not to exceed $25,000, if you or an insured family member suffer a covered loss as a result of an accident while:

1. wearing a seat belt; and
2. driving or riding in a vehicle driven by a driver who is not under the influence of drugs or alcohol.

"Vehicle" means a passenger car, station wagon, van, jeep-type automobile, or truck.

"Seat belt" means those belts that form a restraining system and includes properly used infant and child restraint systems.

Covered family member benefit amounts will increase based on the Family Plan benefit formula.

Continuation of Medical Coverage Funding Benefit Provision.
If loss of life are payable as the result of a covered injury to you and if your eligible family members are insured persons on the date of the accident, one of the following two benefits will also be payable.

Benefit Paid in Three Equal Annual Payments

 

We will pay a benefit for continuation of the Insured Person's medical coverage pursuant to the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). This benefit will be paid in three equal annual payments. Each payment will equal the lesser of:

3% of the Insured's Principal Sum; or
$3,000.

However, before we make the first payment and before we make each of the next two payments, we must receive proof that the payment will be used for continuation of the Insured Person's medical coverage pursuant to COBRA. Payment will be made immediately upon our receipt of such proof. If proof is not provided for a particular payment, will will make neither that annual payment nor the subsequent annual payment(s).

 

 

Payments will be made to the Insured Person who is your spouse on the date of the accident. If there is no such Insured Person, payments will be made to or on behalf of your dependent children who are Insured Persons on that date.

 

 

Benefit Paid in a Single Sum

If proof for the first payment under 1) above is not provided, we will pay to your beneficiary one payment equal to the lessor of A. or B. defined in 1) above. Payment will be made at the end of the period permitted by COBRA for election of continuation of medical coverage. No other payments will then be made pursuant to this provision.

 

 

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Additional features included
at no extra cost.

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Air travel coverage.
You are paid for any covered loss you suffer as a passenger (but not as a pilot or crew member) on any aircraft used for the transportation of passengers, including those suffered while boarding or deplaning such aircraft. Coverage while riding in an aircraft owned, operated, or leased by (or on behalf of ) your employer must be agreed to in writing by the insurance company.

Disappearance.
Your full benefit amount will be paid to your beneficiary if you are not found within one year of the disappearance, sinking, or wrecking of a conveyance in which you were riding when a covered accident occurred.

Exposure to the elements.
If you are exposed to the elements as the result of an accident and suffer any loss otherwise covered under the policy, your benefits will be payable.

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Benefits are always paid in addition to
any other insurance coverage you have . . . group or individual, government or private!

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Effective date.
Your insurance will be effective on the first of the month after we receive your enrollment form.

Terminations.
As long as the plan is in force, you are an eligible employee, and you pay your premium, your coverage remains in effect. Your family members will remain insured as long as they are eligible, you are covered and their premium is paid. Handicapped children shall remain insured, regardless of age, for as long as they continue to be handicapped and your coverage remains in force.

Exclusions.
No benefits will be paid for losses caused by or resulting from: suicide or attempts while sane, self-destruction or attempts while insane; declared or undeclared war or an act of either; service in any armed forces (orders to active military service for 2 months or less shall not constitute service in the armed forces); air travel except as described under air travel coverage or sickness or disease.

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Low-cost coverage you can count on.

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Here's all you need to do . . .
Just complete the brief enrollment form and return it to your supervisor. Do not send any money. Premiums will be paid by payroll deduction.

This coverage costs $.23 each month for every $10,000 of benefits for yourself. You may cover yourself and your eligible family members for just $.43 a month for each $10,000 of your benefit amount.

Some frequently selected benefit amounts and corresponding monthly costs are shown below. 

Monthly Premiums

Selected Principal Sum	Employee Coverage	Family Plan
$25,000	.63	1.18
$50,000	1.25	2.35
$75,000	1.88	3.53
$100,000	2.50	4.70
$150,000	3.75	7.05
$200,000	5.00	9.00
$250,000	6.25	11.75
$300,000	7.50	14.10

Your monthly premium will always be based on your selected benefit amount regardless of age.

NOTE:  If an employee and spouse are both eligible as employees for this program, only one may enroll for the Family Plan. The employee insured as a spouse may also enroll for the Employee Only Plan but the amount selected, when combined with the amount for which they are insured under the Family Plan, may not exceed the amount for which they are eligible as an employee.

This insurance plan is underwritten by the Continental Casualty Company of Chicago, Illinois, one of the CNA Insurance Companies.