Advantage Series Accident Indemnity Protection that surrounds you and your family.
This is an Accident Indemnity Insurance Policy Underwritten by ManhattanLife Insurance and Annuity Company
ASACC-BR 0721
Advantage Series Accident Indemnity
Supplemental Insurance for your employees and their families
As healthcare costs continue to rise, the need for supplemental insurance coverage becomes imperative. An Accident Indemnity plan from ManhattanLife’s Advantage Series can help address your employees’ concerns by offering them supplemental coverage for the associated costs of Accidents and Injuries. For each new Covered Accident, Advantage Accident Indemnity plans provide cash benefits for expenses that major medical insurance may not fully cover. We offer three plans along with optional benefits and riders to provide enhanced financial protection. In the event of a Covered Accident, specific benefit amounts are paid out for:
• Initial Emergency Care • Inpatient Hospital Care • Surgical Care
• Follow-Up Care • Recovery Care • Preventative Care
Key Features • Guaranteed Issue coverage*, with no health questions or medical exams! • Both Employee and Family coverage are available, providing protection for the individual and those they care about most.
Accidents Happen More than one in four of today’s 20-year-olds can expect to be out of work for at least a year because of a disabling condition before they reach the normal retirement age. 1
2.8 million
There were approximately 2.8 million nonfatal workplace injuries and illnesses reported by private industry employers in 2017. 2
There were 882,730 occupational injuries and illnesses in 2017 that resulted in days away from work in private industry. 2
*subject to a minimum of 5 lives enrolled 1- 2 Source information on back.
Plan Comparisons
Benefits are payable only as the result of treatment received for an Injury due to a Covered Accident. Limitations Apply. BENEFIT DESCRIPTION VALUE CLASSIC PREFERRED Urgent Care Payable for initial treatment within 60 days of covered accident. Payable once per covered accident. $200 $150 $200 Emergency Room Care Payable for initial treatment within 30 days of covered accident. Payable once per covered accident. $200 $150 $200 Doctor's Office Care Payable for initial treatment within 60 days of covered accident. Payable once per covered accident. $150 $75 $100 Follow-Up Visits Payable twice per covered accident. $100 $50 $100 Ground Ambulance Payable for transport in an ambulance by ground due to an Injury as a result of a Covered Accident. Maximum of one transport per accident. $500 $150 $300 Air Ambulance Payable for transport to a hospital. $1,500 $500 $1,000 First Hospital Admission Payable once per covered accident, once per Calendar Year. $1,000 $750 $1,500 Hospital Confinement Payable for each day an insured person is confined as an inpatient to a hospital up to 365 days per covered accident. $250 $150 $300 ICU Admission Payable if ICU admission is within 48 hours of hospital admission. $1,000 $750 $1,500 ICU Confinement Payable each day an insured person is confined to a hospital Intensive Care Unit up to 30 days per covered accident. $500 $300 $600
X-Ray: $150 Imaging: $100
X-Ray: $100 Imaging: $75
X-Ray: $150 Imaging: $100
Diagnostic Benefits Payable for x-rays, medical imaging (MRI, CT Scan), or EEG. Not payable if Concussion Benefit is paid.
Medical Appliances Payable once per covered accident. Physical Therapy 10 visits per covered accident. Chiropractic Treatment 3 visits per covered accident. Accidental Death* Payable to the named beneficiary.
$300
$150
$300
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$45
$90
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$45
$90
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$50,000 $75,000
* 50% of employee benefit for spouse and 25% of employee benefit for child(ren)
BENEFIT DESCRIPTION
VALUE CLASSIC PREFERRED
Dismemberment* Payable according to a schedule based on the specific loss incurred. Common Carrier* Payable if death results from an accident while the insured is a fare paying passenger on a commercial airline, passenger train, or intercity bus.
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$50,000 $75,000
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$100,000 $150,000
Blood and Plasma Payable if received within 90 days of covered accident.
$50 - $250
$50 - $500
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One: $750 Multiple: $1,500
One: $750 Multiple: $1,500
Prosthesis (One or Multiple) Payable once per accident for a device or devices needed due to an accident.
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Train/Plane: $100 Bus: $50
Train/Plane: $100 Bus: $50
Train/Plane: $200 Bus: $100
Transportation Payable if the insured person needs care not available locally and more than 50 miles away from their residence. Family Lodging Payable for an adult family member if an insured person is hospitalized more than 100 miles from home. Maximum 30 days. Burns Payable according to a schedule for 2nd and 3rd degree burns if treatment is received within 72 hours of the covered accident. Fractures Payable according to a schedule if diagnosed and treated by a doctor within 90 days of the covered accident. Dislocations Payable according to a schedule if diagnosed and treated by a doctor within 90 days of the covered accident. Lacerations Pays a benefit if a covered person receives a laceration from an injury received because of a covered accident. Laceration must be repaired with stitches by a doctor within 72 hours after the covered accident. The amount paid will be based on the length of the laceration. The covered person may receive a laceration that does not require stitches. If treated by a doctor within 72 hours after the covered accident, benefit will pay the appropriate amount shown in the certificate. Repaired Ligaments Payable if treatment is received within 60 days of the covered accident and surgical repair is performed within 90 days. Repaired Tendons Payable if treatment is received within 60 days of the covered accident and surgical repair is performed within 90 days.
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$50/night $100/night
$100 - $10,000
$100 - $10,000
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$70 - $6,000
$140 - $12,000
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$10 - $3,600
$20 - $7,200
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$25 - $100 $50 - $200
$300 - $600
$600 - $1,200
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$300 - $600
$600 - $1,200
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* 50% of employee benefit for spouse and 25% of employee benefit for child(ren)
BENEFIT DESCRIPTION
VALUE CLASSIC PREFERRED
Repaired Knee Cartilage Payable if treatment is received within 60 days of the covered accident and surgical repair is performed within one year.
$300 - $600
$600 - $1,200
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Repaired Rotator Cuff Payable if surgical repair is performed within one year.
$300 - $600
$600 - $1,200
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Ruptured Disc Payable if treatment is received within 60 days and surgical repair is performed within one year.
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$500
$1,000
Exploratory Surgery Payable if Injury does not require surgical repair. Thoracic, Open Abdominal or Cranial Surgery Excludes hernia
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$200
$400
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$1,500 $3,000
Ambulatory Surgical Center Facility and/or Outpatient Hospital Facility Payable once per covered accident for surgery performed in an Ambulatory Surgical Center Facility or Outpatient Hospital Facility. Anesthesia Administered for a covered surgery where a benefit is being paid.
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$150
$300
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$150
$300
Epidural Pain Management
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$100
$200
Coma Payable if the comatose state lasts more than 30 days and diagnosis indicates that permanent neurological deficit is present. Concussion Payable if diagnosed within 72 hours of the covered accident using medical imaging.
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$10,000 $20,000
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$100
$200
Crown: $150
Crown: $300
Dental Emergency Payable for injury to sound natural teeth.
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Resulting in Extraction: $50 Surgical Repair: $150 Removal of Foreign Body: $50
Resulting in Extraction: $100 Surgical Repair: $300 Removal of Foreign Body: $100
Eye Injury Benefit Pays a benefit for eye injuries requiring surgical repair, for an Injury received as a result of a Covered Accident and the insured injures an eye, doctor repairs the eye through surgery, and the eye surgery occurs within 90 days after the Covered Accident. For eye injuries requiring removal of a foreign body, benefit pays the amount selected if a Doctor removes a foreign body from the eye. Gunshot Wound Payable once per covered accident. Must require treatment by a doctor and surgery.
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$750
$1,500
Occupational HIV Payable once per lifetime.
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$300
$600
BENEFIT DESCRIPTION
VALUE CLASSIC PREFERRED
Paralysis (Paraplegia / Quadriplegia) Payable if paralysis lasts more than 90 days and is diagnosed by a doctor within those 90 days Youth Organized Sports Benefit Increases the total benefit paid by 10% to a maximum of $1,000 if the injury to a dependent child occurs during an organized sports event or scheduled practice.
$12,500- $25,000
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10%
10%
Optional Benefits & Riders Choose to make some or all of these optional benefits/riders available to employees to further enhance coverage:
Waives premiums after being disabled for six consecutive months due to a Covered Accident.
Total Disability Premium Waiver
Pays a $50 benefit when an insured receives a covered screening. Up to 1 per calendar year per insured.
Well-Being Benefit
Those who’ve faced household medical bill problems report struggling to make payments, both for their medical and non-medical bills. 61% say they have been late on a payment for a medical bill, and 56% say they’ve missed a payment. Similarly 56% report being late and 46% report missing payments for non-medical. 3
The average cost of an emergency room visit in 2017 was $1,389. That only represents the cost of entry for emergency care, and doesn’t include charges for things like blood test, IVs, drugs, and other associated treatments. 4
3- 4 Source information on back.
How does the Accident Indemnity Plus Plan Work?
Below are a couple of examples of how benefits can work for employees in the event of an accident.
Scenario One
Scenario Two
The Horseback Riding Incident Jeanette was riding her horse one clear morning. As she was riding, her foot slipped out of the stirrup, causing the horse to stop suddenly. Jeanette was thrown 10 feet to the ground. Through her employer, Jeanette had the Classic Accident Indemnity Plan from ManhattanLife’s Advantage Series. She was treated in the Emergency Room, had to stay in the hospital for two nights and had to have an X-Ray of her foot.
The Sibling Rivalry Incident David and John were playing outside. While wrestling, David accidentally pulled John’s arm too hard, dislocating his elbow. John is a covered dependent under his dad’s Preferred Accident Indemnity plan from ManhattanLife’s Advantage Series. John was taken to the Emergency Room, examined, treated and released.
Treatment
Benefit
Treatment
Benefit
Emergency Room Visit Dislocation Benefit - Elbow
$200
Emergency Room Visit First Hospitalization
$150 $750 $300 $100
$1,000
Daily Hospital Confinement
Total Benefit Received: $1,200
X-Ray
Total Benefit Received: $1,300
Accident Insurance Helps Attract Employees According to a Business Wire August, 2020 Survey: More than two-thirds of employees look to Voluntary Benefits as a deciding factor for whether they work for and stay with an employer. This is done at no direct cost to the employer.
In addition, it may help employees feel comfortable selecting voluntary benefits that have been given the seal of approval by their organization. Payroll deducting premiums allows a more simplified process when paying for coverage.
Underwritten by: ManhattanLife Insurance and Annuity Company 10777 Northwest Freeway, Houston, Texas 77092
Benefits and riders may vary by state and may not be available in all states. This is not a complete disclosure of plan qualifications and limitations. To access the complete disclosure list for the Advantage Series Accident Indemnity product, visit disclosure.manhattanlife.com . Please review this information before applying for coverage. The amount of benefits provided depend on the plan selected. Premiums will vary according to the selection made. THIS POLICY PROVIDES LIMITED BENEFITS. This brochure does not apply to Connecticut. Please refer to the CT - specific brochure for product approval in that state. Policy: M-8026 Well-Being Benefit: M-1775 Additional Benefits Rider: M-8326 Offer your employees added security and peace of mind with Worksite Advantage Insurance. ManhattanLife knows the key to long term success is service - to our producers, to employers like you, and most importantly, to our ultimate customers - your employees . For more information regarding rates and how to apply, visit the Agent Resource Center or email marketingmail@manhattanlife.com SOURCE INFORMATION 1 disabilitycanhappen.org/disability-statistic March 28, 2018; 2 Bureau of Labor Statistics, 11/08/2018 News Release: Employer-Reported Workplace Injuries and Illnesses; 3 The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times Medical Bills Survey, January 5, 2016 4 https://bettersolutionsforhealthcare.org/usa-today-really-astonishing-average-cost-of-hospital-er-visit-surges-176-in- a-decade-report-says/#:~:text=The%20average%20emergency%20room%20visit,IVs%2C%20drugs%20or%20other%20 treatments.
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