Group accident insurance plans

Though most people do not like to think about it, accidents can happen—and they can be devastating. They can occur without warning, and most individuals are not financially or emotionally prepared for them. However, offering a group accident insurance plan as part of your employee benefits package can help your employees in the event of an accident.

Accident Benefits
Group accident insurance plans typically offer coverage for the following:

• Inpatient expenses incurred at a hospital that are applied to the deductible, copayment or coinsurance for the plan
• Outpatient expenses applied the same way as inpatient benefits. These charges are incurred at the outpatient center of a hospital, ambulatory surgical center, day surgery facility, MRI facility or emergency room.
• Sickness inpatient expenses due to illness resulting from an accident
• Complete dislocations of the hip, knee, shoulder, foot, ankle, hand, lower jaw, wrist, elbow, finger and toe
• Complete fractures of the hip, thigh, vertebrae, vertebral process, pelvis, skull (simple and depressed), leg, forearm, hand, wrist, foot, ankle, kneecap, shoulder blade, collarbone, lower jaw, upper arm, upper jaw, facial bones (except teeth), coccyx, rib, finger and toe
• Injuries requiring surgery to eyes, tendons, ligaments, ruptured discs and torn knee cartilage
• Burns (generally second-degree burns of at least 25 percent of the body or third-degree burns covering at least several inches of the body)
• Lacerations of varying lengths
• Air ambulance, normal ambulatory service, and blood or plasma services
• Hospital admissions and confinement
• Medical fees, including X-rays, office visits and emergency room treatment
• Accidental death and dismemberment

 
All of these services are covered at varying degrees and up to differing dollar amounts depending on the type of plan selected.

Limitations and Exclusions
The following instances are typically not covered under a group accident insurance plan:

• Participation in war or any act of war (declared or not)
• Committing or attempting to commit suicide
• Self-inflicted injuries
• Injuries that occurred while traveling outside of the United States, Canada, Mexico and/or Puerto Rico
• Injuries sustained while driving a motor vehicle in a race, stunt show or speed test
• Injuries sustained while operating, learning to operate or serving as a crew member on an aircraft or jumping from or falling out of an aircraft. This does not apply to fare-paying passengers.
• Participation in an illegal activity
• Participation in a professional or semi-professional organized sport
• Injuries sustained while intoxicated or under the influence of a narcotic, unless prescribed by a physician
• Costs related to diseases or bodily or mental illness

 
Group accident insurance can be a financial lifesaver for your employees. Consider adding this benefit to your employee benefit package this enrollment season.