NOT available in OR

4 great components
:

Accident Medical Insurance - covers you and your entire family

Ambulance ride is covered in Full, and Air Ambulance up to $4,000

Accidental Death & Dismemberment Insurance for primary insured persons

Rx Prescription Card


$5000 Accident Medical + Accidental Death & Dismemberment Insurance

$5,000 Accident Medical Insurance - covers you and your entire family up to $5,000 for medical expenses due to an accident with only a $100 deductible; the plan then pays 100% of the medical costs to $5,000 of reasonable and customary charges.

Ambulance ride is covered in full, and Air Ambulance up to $4,000!

No Limit on how many times an insured's family uses the policy.

 This benefit includes $1,000 of Accidental Death & Dismemberment Insurance for primary insured only.


POLICYHOLDER INFORMATION

SCHEDULE OF BENEFITS

Policyholder:

Association for Independent Managers

Policy Effective Date:

December 1, 2006

Eligible Persons:

Members of the Association for Independent Managers under age 65 and their Dependents

Date of Enrollment:

The first of the month following Our receipt of the Eligible Person’s completed enrollment form.

Scope of Coverage:

24-Hour Accident Coverage


COVERED CHARGES

Treatment, services or supplies incurred for:

Hospital room and board and general nursing care up to the semi-private room rate limited to 30 days.

Intensive Care.

Hospital miscellaneous expense

Operating room expense

Doctor’s fees for surgery. No more than one surgical procedure will be covered when multiple procedures are performed through the same incision or in immediate succession. However, benefits will be payable up to 1.57 times the surgical procedure charge when more than one surgical procedure through different operating fields are performed during the same surgical session.

Assistant surgeon expense.

Anesthesia services

Doctors visits, inpatient and outpatient.

Hospital Emergency care or care in other Emergency facility.

Outpatient services

X-ray and laboratory services

Ambulance expense

Durable Medical Equipment

Registered Nurse expense


EXCLUSIONS

This Certificate does not provide benefits for:

• Treatment services or supplies which:

• Are not Medically Necessary;

• Are not prescribed by a Doctor as necessary to treat an Injury;

• Are determined to be Experimental/Investigational in nature;

• Are received without charge or legal obligation to pay;

• Are received from persons employed or retained by the Policyholder or any Family Member, unless otherwise specified; or

• Are not specifically listed as Covered Charges in this Certificate.

• Intentionally self-inflicted Injury, violating or attempting to violate any duly enacted law.

Injury by acts of war, whether declared or not.

• Injury received while traveling or flying by air, except as a fare-paying passenger on a regularly scheduled commercial airline.

• Injury or Sickness arising out of or in the course of employment and which is paid or received under any Workers’ Compensation or Occupational Disease Act or Law.

• Treatment of illness, disease or infections, except pyogenic infections or bacterial infections which result from the accidental ingestion of contaminated substances.

• Heat exhaustion.

• Treatment of Osgood-Schlatter’s disease; appendicitis; osteomyelitis; pathological fractures; congenital weakness; hernia; TMJ; fainting; headaches; boils; spondylolysis; osteochondritis dissecans; detached retina unless directly caused by Injury; or Mental or Nervous Disorders whether or not caused by Injury.

• Injury contributed to by the use of alcohol or drugs not prescribed by a Doctor.

• Suicide or attempted suicide while sane; or self-destruction or an attempt to self-destroy while insane.

CAXXEX102

• Dental treatment, except as specifically stated.

CAFLEX300

• Loss resulting from being legally intoxicated or under the influence of alcohol as defined by the laws of the state in which the Injury occurs.

• Loss resulting from being under the influence of any drugs or narcotic unless administered on the advice of a Doctor.

• Injury sustained while operating, riding in or upon, mounting or alighting from, any two- or three- wheeled recreational motor/engine driven vehicle or snowmobile or all terrain vehicle (ATV).

CAXXEX400

• Injury which occurs while the Insured is on active duty service in any armed forces. Reserve or National Guard active duty for training is not excluded unless it extends beyond 31 days.

• Injury sustained flying in an ultra light, hang gliding, parachuting or bungi-cord jumping, byflight in a space craft or any craft designed for navigation above or beyond the earth’s atmosphere.

• Treatment in any Veteran’s Administration or federal Hospital, except if there is a legal obligation to pay.

• Cosmetic surgery, except for reconstructive surgery on an injured part of the body.

CAXXEX600

• Covered Charges incurred outside of the United States or its possessions, unless such Covered Charges are incurred while the Covered Person is on a trip of not more than 30 days.

CAXXEX700

• Injury resulting from participation in organized sports for Covered Persons over the age of 18.

• Physical Therapy or Physiotherapy, spinal manipulation, and manual manipulative treatment or therapy, where allowed.



Rx Prescription Card

Rx offers access to your maintenance medications at affordable prices that will be shipped directly to your doorstep. Plan Members will save on average 48% on the cost of their medications.

The Rx Card has 3 Great Components

Walk-In Pharmacy Discount - Plan Members will also receive the Rx Discount Card, which allows you to shop locally and receive discounts on your immediate need medications. The Rx Discount Card is accepted by over 42,000 pharmacies so you won't have to look far to save money.

$5 Generic Mail Order - As part of our commitment to lowering healthcare costs, Rx offers over 400 prescription drugs at only $5 per 30 day supply or $15 for a 90 day supply.

Brand Name Mail Order - Plan Members can save even more with the Rx Maintenance Mail-order Service. It's as easy as 1-2-3.

Step 1 Members can simply go on-line or call to receive a drug cost comparison on high cost medications.

Step 2 Submit your order form, doctor's prescription and payment method.

Step 3 Receive your medications right at your doorstep.

o On-line Easy Refills
o Refill reminders

 

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