Q. Why is Accidental Death and Dismemberment insurance important?
A. An accidental death occurs every four minutes in the U.S., making accidents the fourth leading cause of death.* Other types of life insurance may not cover accidental death or dismemberment as a result of an accident. Accidental Death and Dismemberment (AD&D) offers easy, affordable ways to give your entire family guaranteed insurance protection, 24 hours a day, 365 days a year.
There is no medical exam and your acceptance is guaranteed. The benefits provided are payable in addition to any insurance that may be in effect at the time of the accident.
* Source: National Safety Council, Injury Facts, 2016 Edition.
Q. Who is the insurance issuer for SEIU AD&D coverage?
A. The Prudential Insurance Company of America (Prudential) issues SEIU AD&D coverage. Our alliance with the company is based on a rigorous process of evaluating the market to find the best products and services for SEIU members. Prudential has one of the most recognized and trusted brand symbols: The Rock®, an icon of strength, stability, expertise and innovation.**
** Source: www.prudential.com/about, 2017.
Q. Can my spouse and dependent children be covered under this program?
A. Yes, as long as the member of the SEIU has coverage under the AD&D, there is optional coverage for the spouse and/or children. The coverage amount you select for the family will determine the coverage levels for each person in your family. Unmarried children can be covered up to age 26.
Q. How much does AD&D pay and what is covered?
A. AD&D insurance benefits are as follows:
- From $25,000 to $250,000, if the covered Member dies in an accident or loses a limb or suffers a coma, paralysis, loss of sight or other covered losses in an accident.
- If a loss of life occurs in a car accident and the covered individual is wearing a seat belt (in the prescribed manner), or is sitting in a car seat equipped with an air bag and wearing a seat belt, the plan pays an additional benefit of 10% of the coverage amount, up to $10,000.
Supplemental Benefits Covered:
- Loss due to exposure and disappearance
Exposure to the elements is considered an accidental loss. If the insured member’s body is not found within a year of disappearing, they will be presumed dead.
- Loss due to coma
The plan pays one percent of the coverage amount for each month the insured remains in a coma that results from an accident. The coma must be permanent and continuous, beginning within one month of the accident. The benefit is payable up to 100 months while the person remains in a coma.
- Return of remains
If accidental death occurs in a foreign country or outside a 100-mile radius of the insured’s home, the plan pays for the preparation and transportation of the body for cremation or burial. The amount is the lesser of the actual covered expenses, or $5,000.
- Felonious assault
If a member suffers a loss due to aggravated assault while working for the employer or on an authorized business trip, an additional benefit the lesser of ten percent of the benefit amount or $10,000 will be paid.
- Child expense reimbursement
Day care is covered for dependent children under the age of 13, if the member or spouse dies in an accident covered by the policy. The annual benefit is the least of the actual daycare cost, five percent of the insured’s coverage amount, or $5,000 a year for up to four consecutive years or until the child reaches age 13.
- Tuition reimbursement
Dependent Children: The plan pays an annual benefit of up to four years of tuition for dependent children up to age 25 who are full-time students in any institutions of higher learning or high schools. The annual benefit is the least of the actual tuition (excluding room and board), five percent of the member’s coverage amount, or $5,000 a year. Dependents must be enrolled in an institution of higher learning within 365 days of the insured’s death.
- Educational reimbursement for spouse/domestic partners
The plan provides tuition reimbursement for a professional or trade program to prepare a spouse/domestic partner for work that will meet the financial needs of a family. The benefit is the least of the actual tuition, five percent of the member’s coverage amount, or $5,000. Enrollment in an educational program must occur within 12 months of the member’s death.
- Common accident benefit
If the member and spouse/domestic partner both die in the same accident, the plan pays a benefit for the spouse’s/domestic partner’s death. The amount paid is the difference between the member’s coverage amount and the spouse’s coverage amount.
- Critical periods payments benefit
The plan provides a benefit for the surviving spouse equal to one half percent of the member’s coverage amount for each of the 6 months immediately following the member’s death.
- Child loss
This is a benefit that pays an additional amount if a covered child suffers a loss in an accident, but does not die. The amount payable for the loss is the amount payable for that child’s loss or $100,000, whichever is less.
- Bereavement and trauma counseling
This additional benefit applies if the person requires bereavement and trauma counseling because you, your Qualified Dependent spouse or Domestic Partner or your Qualified Dependent child suffer a Loss. It is payable for Bereavement and Trauma Counseling Sessions that are held within one year after the date of the accident causing the Loss.
- Monthly mortgage payment
The Monthly Mortgage benefit pays the lesser of your mortgage payment or $2,500, for up to 12 months to your surviving spouse or domestic partner who owned the property and shared the mortgage responsibility with you if you suffer a loss of life. The benefit continues to the earliest of these events: 1) the mortgage is paid off, 2) the house is sold, 3) your spouse or domestic partner dies; or 4) the 12th benefit payment.
- Monthly rehabilitation expenses
This benefit applies if a person suffers a loss and a doctor determines that rehabilitation is necessary to aid the person in returning to the normal activities of a person of the same age and gender.
- Critical burns
The plan provides a benefit if a member suffers critical burns that result in permanent disfigurement while a Covered Person under the Coverage and the burns occurred while working for your employer.
Q. Do I need to have a medical exam?
A. No medical exam is required and there are no medical questions to answer, so your acceptance into the plan is guaranteed.
SEIU has retained Members United Insurance Agency to manage Insurance Programs for its Members. Members United Insurance Agency is not affiliated with The Prudential Insurance Company of America.
This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Department of Financial Services.
IMPORTANT NOTICE: THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKESS.
SEIU Accidental Death & Dismemberment Insurance coverage is issued by The Prudential Insurance Company of America, Newark, NJ. The Booklet-Certificate contains all details including any policy exclusions, limitations and restrictions, which may apply. Contract Series 83500. CA COA #1179, NAIC #68241.
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