For Members of Association for Healthy Ideas and Resources (AHIR)
Accident Expense Coverage for Members and their Families
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Pays 100% of Covered Medical Expenses after satisfaction of the Deductible up to the coverage maximum
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Use any doctor or hospital
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Accidental Death & Dismemberment benefits
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Emergency Helicopter Air Ambulance benefits
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Automatic acceptance through age 64
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NEW CallMD, your lifeline for quick, high quality, non - emergency healthcare, 24 hours a day, 7 days a week,! Up to 12 calls per year per family! Prescriptions for non-narcotic medications may be written over the phone for you and your dependent children of all ages when sufficient medical history is available.
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Benefits are paid directly to you
Select your state for availability, benefits and pricing:
Accident Medical Expense benefits are excess to other coverage.
**Accident Death & Dismemberment benefit are at lower amounts than shown for spouse and dependents.
This site depicts only a summary of services provided. For complete details, including exceptions and limitations refer to Membership material.
MEMBERSHIP
ALSO INCLUDES DISCOUNTS AND DIVIDENDS *
CallMD:Members have access to a nationwide network of medical doctors available 24 hours per day / 7 days per week for consultation or routine medical needs through the convenience of a toll free phone number, without having to take time to make an appointment or wait in line at a doctor's office. CallMD maintains members' electronic medical records (EMR) in a highly secured, Internet accessible environment and makes this information available to our network doctors prior to a doctor consultation. Furthermore, a CallMD Doctor can write a prescription where allowed by law when sufficient medical history is available. (CallMD cannot write prescriptions for narcotics or DEA controlled substances.)
Enhanced Benefit Card:Dental Savings up to 40% off or more with almost 100,00 Dentists, Vision & LASIK Savings of 10%-50%, Lab Tests Savings of 10%-70%, RX Savings up to 20%, Hearing Savings up to 65%, Diabetic Supplies Savings of 15%-48% , X-Rays & Imaging Savings of 10%-80%, Chiropractic Savings of 10%-60%
The Dividend Club:Members will earn Dividends (paid quarterly to you) on Merchandise, Services, Travel & Entertainment when you shop from our On-line Mall and make a purchase. Choose from retailers like these, just to name a few, and get the dividends: Walmart.com, Target.com, BestBuy.com, CircuitCity.com, CompUSA.com, DisneyStore.com, OfficeMax.com, BrooksBrothers.com, Brookstone.com, Buy.com, EddieBauer.com, LizClairborne.com, FOA.com, FOSSIL.com, HotelDiscounts.com, Jcrew.com, etc.
Car Rental Services:Provides discounts at Alamo, National, Hertz and Avis
Rewards Network:America’s Premier Dining Rewards Program and Hotel Discounts. Save up to 20% off every meal plus up to 15% off your hotel room rate
BENEFITS DETAILS
SUMMARY OF GROUP BENEFITS FOR ACCIDENTS ONLY
Accidental Death Description of Coverage:
Member: 100%
Eligible Spouse: 50%
Eligible Dependent Children: 10%
Medical expense benefits due to accidents:
Maximum benefit per injury: Based on plan selected
Deductible amount: $100
Coinsurance percentage: 100%
Benefit period: Provided treatment begins within (90) days from the date injury. Benefits are payable for 52 weeks from the date of an injury. The injury must occur after the effective date and prior to the expiration date and care must be medically necessary.
Description of medical benefit:
1.
Covers principal, eligible spouse and eligible dependents.
2.
Pays 100% of covered medical expenses after satisfaction of the $100 deductible up to the coverage maximum.
3.
Medical expenses coverage maximum per injury or accident.
4.
Use any doctor, emergency room or hospital of your choice.
5.
Pays directly to you. Medical Services means the costs for: medically necessary treatment by a physician or dentist; hospital room and board; dental work due to injury to sound natural teeth up to the benefit limit specified in the policy; drugs; medicines; diagnostic tests and x-rays; treatment performed by licensed medical professionals; or rental of durable medical equipment.
6.
Benefits payable excess of any other collectible insurance coverage.
Probationary period: 30 days, see the Description of Coverage for details.
Effective date: 1st of the month following probationary period.
A full description of the current coverage, exclusions and certificate of insurance can be found at:
www.gacquote.com or you can call customer service at: 1-800-457-3405
BENEFITS ARE NOT PAYABLE FOR LOSS DUE TO SICKNESS
Policy Number may vary by state. See your certificate of insurance or website for more information regarding your policy number. United States Fire Insurance Company: Administrative Offices: 5 Christopher Way Eatontown, N.J. 07724
This Description of Coverage is a brief description of the important features of the insurance plan. It is not a contract of insurance. The terms and conditions of coverage are set forth in your policy issued to: Association for Healthy Ideas and Resources (AHIR). The policy is subject to the laws of the state in which it was issued. Coverage may not be available in all states or certain terms or conditions may be different if required by state law. Please keep this information as a reference.
Exclusions and Limitations
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;
Are not specifically listed as Covered Charges in this Certificate.
Treatment of illness, disease, or infections, except pyogenic infections or bacterial infections which result from the accidental ingestion of contaminated substances.
Injury by acts of war, whether declared or not.
Injury covered by Worker's Compensation or the Occupational Disease Law or mandatory no-fault automobile insurance.
Injury received while traveling or flying by air, except as a fare paying passenger on a regularly scheduled commercial airline.
Suicide, attempted suicide, or intentionally self-inflicted Injury while sane.
Injury sustained while committing or attempting to commit a felony.
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 intoxication or the use of any drug or agent classified as narcotic, psycholytic, psychedelic, hallucinogenic, or having a similar classification or effect, unless prescribed by a Doctor.
Injury 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.
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 60 days.
Injury resulting from participation in organized sports for covered persons over the age of 18.
THIS IS LIMITED ACCIDENT MEDICAL EXPENSE INSURANCE. IT IS AN ACCIDENT ONLY POLICY AND DOES NOT COVER LOSS OR EXPENSE RESULTING FROM SICKNESS, DISEASE, OR BODILY INFIRMITY.
In order to receive benefits, a covered person must sustain an injury while the policy is in force and such injury directly and independently causes a loss covered by the policy. This material is designed for information al purposes only and merely summarizes the benefits available. All benefits are subject to the contracts, master group insurance policy and nay amendments, which alone constitute the agreement under which payments are made at the time of claim.
All benefits provided by this insurance are subject to the terms, definitions, conditions, exclusions, and limitations, of the group policy. To obtain more information about this benefit, please call 1-800-457-3405. All members of The Association for Healthy Ideas and Resources are eligible to receive these benefits. The insurance benefits are underwritten by United States Fire Insurance Company of 5 Christopher Way, Eatontown, NJ 07724, issued to the AHIR and administered under contract by Mednet Benefits. Coverage is not provided for loss due to a pre-existing condition. The underwriting risks, financial obligations and support functions associated with the products issued by United States Fire Insurance company of 5 Christopher Way, Eatontown, NJ 07724 are it's responsibility. United States Fire Insurance Company is responsible for its own financial condition and contractual obligations.
Your membership is backed by an initial 30 day money back guaranty. If you are unsatisfied for any reason with your benefits membership or need help in filing a claim or for general information with your benefits, please call our membership service department toll free at: 1-800-457-3405 Mon through Thurs 7:30 AM to 5 PM and Friday 7:30 AM to 2:30 PM—MST.
DEFINITIONS
DEFINITIONS (Membership Levels $2,500, $5,000, $7,500 and $10,000)
ACCIDENT: A sudden event which results in an Injury.
INJURY: Bodily injury due to an Accident which:
results directly and independently of disease, bodily infirmity, or any other causes;
solely, directly, and independently of all other causes results in medical expense;
occurs after the effective date of the Covered Person's coverage; and
occurs while the person's coverage is in force.
All injuries sustained in any one Accident, including all related conditions and recurrent symptoms of these Injuries, are considered a single Injury.
INSURED PERSONS: include all eligible covered members and their lawful spouses.
TERMINATION
24-Hour-A-Day Accident Coverage. Coverage will terminate at the earlier of:
the date the policy terminates;
the date the covered person ceases to be an Eligible Person; or
the end of the period for which any applicable premium had been paid.
GENERAL POLICY PROVISION
Benefits are payable for Eligible Expenses for non-work related Injuries.
AHIR TERMS
AHIR TERMS AND CONDITIONS
1. Member understands that Association for Healthy Ideas and Resources (AHIR) is not an insurance company or program. Accident Benefit Payments are made by the administrator for the insurance company issuing the blanket coverage to Members.
2. AHIR provides savings to its members on services through a number of sources. The current list of benefits may be modified through additions or deletions. A quarterly newsletter, posted on our website or sent via e-mail, will keep Members up to date on benefits and other pertinent information.
3. Payments for the AHIR Program are due in advance. Payments will be drafted on or about 15 days before the due date. If you choose to cancel your program, it is your responsibility to make sure that your membership card and a written request for cancellation are sent to AHIR at least 15 days prior to the anniversary of your effective date in order for your account not to be charged for additional fees.
4. Member hereby appoints, Association for Healthy Ideas and Resources (AHIR) President, or failing this person, a AHIR Director, as proxy holder for and on behalf of the member with the power of substitution to attend, act and vote for and on behalf of the member in respect of all matters that may properly come before the meeting of the members of AHIR and at every adjournment thereof, to the same extent and with the same powers as if the undersigned member were present at the said meeting, or any adjournment thereof. Annual meetings are to be held in Arizona the second Tuesday of August.
5. AHIR reserves the right to terminate any enrollment or deny eligibility in the program for lack of payment to AHIR. Returned checks, insufficient notices on bank drafts or denial by the member's credit card company for payment of the membership fee is deemed to be evidence of non-payment by a member. There will be a $10.00 charge to be reinstated in the program after such denial. If reinstatement for non-payment happens more than once, a $20.00 reinstatement will apply.
6. In the event of any dispute, member agrees to resolve said dispute solely by binding arbitration that shall be governed by the laws of the state of Arizona and enforceable at Scottsdale, Maricopa County.
7. Membership cancelled within the first 30 days of the enrollment date may be eligible for refund if the membership card and written cancellation request are sent to AHIR. The administrative fee is not refundable. Approved refunds will be processed approximately 30 days after cancellation.
8. Membership is effective on the 1st of the month following enrollment acceptance by AHIR.
Member Agreement:
By signing your enrollment form, Member expresses desire to become a member of National Employers Association. Member acknowledges that the discount plans ARE NOT INSURANCE, but membership includes certain limited supplemental insured coverage's. Membership benefits are not a replacement for health insurance coverage nor are they intended as a substitute for health insurance coverage. Membership fees may change for all members, but not individually, with notification.
Discounts and Dividends are not insurance
FAQ
FREQUENTLY ASKED QUESTIONS
When will my benefits become effective?
All effective dates are the 1st of the month following your enrollment.
Do the accident expense benefits coordinate with other coverage?
Yes, the benefits are secondary to other coverage and will coordinate with other insurance.
Do I have benefits outside of the United States?
Yes, if you are traveling for pleasure outside of the United States you will be eligible for benefits.
What is the maximum age for accident benefits?
At age 65 the accident benefits are no longer available to NEA members.
Are dependents eligible as members?
Yes, a spouse under age 65 and dependent children to age 19 or full time student under age 25.
Is there a limit to the number of accidents per year that are covered?
No, the benefits are paid on a per accident occurrence.
What are the payment options?
You may pay by monthly credit card or monthly automatic bank draft.
What other benefits are available to me as a NEA member?
There are many valuable benefits as a NEA member that you will receive in your fulfillment packet or can preview on this web site.
What if I have questions regarding the benefits after I enroll?
You can contact your agent or call our toll free customer service line.
SECURITY & PRIVACY STATEMENT
When you become a GACquote.com customer, you entrust us with your personal data. We consider your data to be private and confidential, and we hold ourselves to the highest standards of trust and fiduciary duty in their safekeeping and use.
General Agent Center (GAC) and our partners will not release information about you or your application, policy or claims information, unless one or more of the following conditions are met:
We receive your prior written consent.
We believe the prospective recipient to be you or your authorized representative.
We are required by law to release information to the recipient.
Questions about your medical history and physical condition are required by our insurance carrier partners and will be released to the insurer so that they may underwrite your insurance application. GAC will not give or sell information about you to any other company, individual, or group without your prior authorization.
GAC will only use information about you to help us better serve your insurance needs or to suggest GAC services or insurance materials that may be of interest to you.
To further protect your privacy, our web site uses the highest levels of Internet security, including data encryption, user names and passwords, and other security tools.
Occasionally, GAC may conduct marketing surveys or research to help us evaluate products, services, and the changing needs of our customers. It is GAC's policy to keep this information confidential.
We will not share individual marketing data gathered from our web site with individuals or business entities not affiliated with GAC.
We know that the privacy of your personal information is important to you. In order to provide you with insurance products of the highest quality and with the service you deserve, it may be necessary for us from time to time to collect nonpublic personal and financial information about you (the "Information") and, in certain situations, to share that Information with others. The following notice describes our policies and practices with regard to your Information.
HOW WE PROTECT YOUR INFORMATION
We maintain physical, electronic and procedural safeguards to protect the Information against unauthorized access and use. We restrict access to the Information to those employees who need access to provide products and services to you and your dependents. The personnel who have access are trained in the proper handling of the Information. Employees who violate this strict level of confidentiality are subject to our disciplinary process.
CATEGORIES OF INFORMATION THAT WE COLLECT
In the normal course of business we may collect the following types of Information:
Information you provide on applications and other forms (including name and address)
Data about your transactions with us (such as types of products you have purchased and your account status)
Information gathered on our Web sites through online forms, site visit data and online information-collecting devices known as "cookies"
HOW WE USE YOUR INFORMATION
We may share your information among the Insurance Companies as permitted by law, including for routine business administration.
We may share information with non-affiliated companies as allowed by law, such as firms that perform services on our behalf, including the administration and marketing of our products. We require these companies to meet strict privacy standards.
We may disclose information to non-affiliated entities when required by law, such as to respond to a subpoena, to prevent fraud or to comply with an inquiry by a government agency.
ACCURACY OF YOUR INFORMATION
We strive to maintain the accuracy of Information that is in our possession about you. In order to help us maintain accuracy, you have the right to reasonably access your information. If you believe any information in our possession is inaccurate, a request can be made to amend or delete the information that you believe to be erroneous. If we concur with the request, we will amend or delete the information in question. You may write our Privacy Office at the address below to receive our complete policy on accessing and amending the Information.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to make the revised Notice effective for the Information we already have about you as well as any Information we receive in the future. If we make any material changes to our policies or practices, we will provide you with a copy of a revised Notice. We will post a copy of the current Notice on our websites. The Notice will contain in the top right-hand corner, the effective date.
You may contact our Privacy Office at:
General Agent Center
15575 North 79th Place, Suite 100
Scottsdale, AZ 85260
Membership with Accident Coverage
