Frequently Asked Questions for Comprehensive Accident Protection 

• Coverage and dependent questions
• Beneficiary questions
• Exclusion questions
• Rate questions

COVERAGE AND DEPENDENT QUESTIONS

Q. I'm concerned that a Workers Compensation offset will reduce my benefit to $0. Is this possible?

A. Yes, however, if your Monthly Benefit Amount would reduce to less than $50 per month due to Other Income Benefits, including Workers Compensation, then the minimum Monthly Benefit Amount under this benefit will be $50 per month.

Q. Why is Comprehensive Accident Protection (CAP) important to have?

A. Consider what would happen if you were unable to work for days, weeks, months from an accident? The UnionSecure Comprehensive Accident Plan is a "catch-all" plan to provide financial relief for almost any kind of accident - from the minor to the severe. First, it pays a daily benefit while you are in the hospital for any kind of accident, no matter where it occurs. Secondly, if the accident is severe enough to cause a disability - one that causes you to become unable to perform the material and substantial duties of your usual occupation - it pays an additional monthly benefit to help relieve the added financial burden caused by your inability to work. And thirdly, if the accident is fatal, the Comprehensive Accident Plan death benefit helps pay the bills if you are gone.

Q. What is a "death benefit"?

A. Death benefit is the amount of money paid to your beneficiary if you die in an accident. The beneficiary is the person you select to receive this payment.

Q. What is an "injury"?

A. Injury means bodily injury resulting directly from accident and independently of all other causes which occurs while the Covered Person is covered under the policy.  Loss resulting from: sickness or disease, except a pus-forming infection which occurs through an accidental wound; or medical or surgical treatment of a sickness or disease; is not considered as resulting from Injury.  

Q. What is a "premium"?

A. The premium is the payment you make for an insurance policy.  

Q. What does it mean to be Totally Disabled?

A. Totally Disabled or Total Disability means a disability which, during the Elimination Period and the first 12 months during which Total Disability Benefits are payable, wholly and continuously prevents you or your spouse from performing the essential duties of your occupation.  

While some policies change the definition over time from "your usual occupation" in the beginning to "any occupation" later on, the UnionSecure coverage continues to define disability based on your usual occupation for the entire benefit period.

UnionSecure disability insurance plan pays benefits after a period of time during which the insured has been continuously disabled for 60 days. Benefits are not payable during the elimination period. Benefits are then paid for up to one year, or until the insured returns to work, dies or reaches the policy termination age of 65.xml:namespace prefix = o /> 

If benefits begin prior to age 65 and the insured turns 65 while collecting benefits, the benefits will continue if the insured remains disabled, until the benefit period would normally end (after a year, or a return to work or at death).

Q. Should I wait until I've satisfied the elimination period to file my claim?

Q. Is there a pre-existing limitation?

Q. Are there any age requirements?

A. Yes, you must be aged 18-59 to qualify and coverage terminates at age 65.

Q. I'm a part-time or seasonal employee. Am I still eligible?

A. Yes, but you must work 20 hours per week or an average of 260 hours per quarter.

Q. Is a medical exam necessary?

A. No, there is no medical exam to take. There are no health questions to answer. This coverage is guaranteed to be issued if you are eligible.

Q. Is coverage available for my spouse or domestic partner?

A. Yes, your spouse or domestic partner can apply - even if you do not.

Q. Does my spouse or domestic partner receive the same benefit as me, the union member?

A. Yes, spouses (or domestic partners) can choose the same benefit or choose a higher or lower benefit level. Spouses and domestic partners are not bound by the coverage the union member chooses.

Q. Can I get coverage for the rest of my family (besides my spouse/domestic partner)?

A. No.

Q. Can I collect more than one benefit with this policy?

A. Yes, if you are injured and must be hospitalized you will receive a daily hospital benefit for each day you are in the hospital. If the injury is serious and causes you to miss work for an extended period of time, you may also collect monthly disability benefits. If your injury should result in death, your beneficiary would also collect a death benefit.

Hospital does not mean any institution or part thereof which is used primarily as a nursing home, convalescent home or skilled nursing facility, a place for drug addicts or alcoholics or a place for rest, custodial care or for the aged.

Q. What is the certificate examination period?

A. Members have 60 days to review the certificate. If you change your mind within that time you are entitled to a full refund of premium less any claims paid.

Q. When does coverage become effective?

A. Coverage becomes effective on the first day of the month after your application is received and you pay your premium.

Q. When do benefits begin?

A. The daily hospital benefit will pay from the first day of hospitalization due to an accident. The disability benefit begins after a 60-day elimination period.

Q. What happens to an insured when an accident occurs but death doesn't occur right away?

A. The coverage will pay if death occurs within 365 days of the accident and the accident is found to be the primary cause of death.

Q. If the insured member dies can my spouse or domestic partner continue coverage?

A. Yes, spouses (or domestic partners) can continue coverage if they are insured with their own policy prior to the members' death.

Q. Will my benefits ever change based on my health status or age?

A. No, the benefits will remain the same until the policy terminates at age 65.

Q. Does this coverage pay if an insured is hospitalized for an accident?

A. Yes, it pays $50 or $100 a day (depending on the coverage selected) for each day an insured spends in the hospital due to an accident with a lifetime benefit of 500 days.

Q. What if hospitalization occurs due to sickness?

A. The coverage pays only for hospitalizations due to accidents. It does not pay for hospitalizations due to sickness or disabilities caused by natural causes, heart attack or other illnesses.

Q. What does the Strike/Labor Dispute Waiver of Premium mean?

A. If an insured is in 1) a lawful, authorized strike by a union or 2) is locked out as a result of a dispute between the union and an employer, the insured doesn't have to pay premiums on this coverage. May not be available for all unions or in all states.

Q. How does the Strike/Labor Dispute Waiver of Premium work?

A. Premiums will be waived beginning with the first premium due date following a strike or lock out. Premium payments will be waived for up to one year, but will resume on the earliest of: 1. One year from when the strike or lockout began, 2. The next premium due date after resolution, 3. Next premium due date after return-to-work offer, or 4. Next premium due date after employment is terminated. May not be available in all states or for all unions.

Q. What is the process for getting the premium waived?

A. The insured must provide written proof of strike or lock out before the wavier of premium begins. It can be a note from the union, or a note from the insured with a newspaper article verifying the sanctioned or forced work stoppage.

Return To Top

Q. Is it mandatory to name a beneficiary?

A. No. If no beneficiary is named for the accidental death benefit it will be paid to the deceased's estate. The daily hospital benefit and the disability benefit are paid to the insured.

Q. Can beneficiaries be changed?

A. Beneficiaries may be changed at any time by calling 1-800-393-0864 to request a beneficiary form or downloading a beneficiary change form.

Return To Top

EXCLUSION QUESTIONS

Q. Are there any exclusions to the policy coverage?

A. The policy does not cover any loss resulting from: a)intentionally self-inflicted injury, suicide or attempted suicide, whether sane or insane; b) war or act of war, whether declared or undeclared; c) Injury sustained while voluntarily taking drugs which federal law prohibits dispensing without a prescription, including sedatives, narcotics, barbiturates, amphetamines, or hallucinogens, unless the drug is taken as prescribed or administered by a licensed physician; d) Injury sustained while legally intoxicated from the use of alcohol.

If your union notifies UnionSecure in writing that you have left the union for any reason other than retirement, then the coverage will be terminated.  

Q. Does a union member who leaves the union lose his coverage?

A. If your union notifies UnionSecure in writing that you have left the union for any reason, then the coverage will be terminated.

Q. Is the coverage available for former union members?

A. No, this coverage is only for active union members. It is a benefit of being a dues-paying union member.

Return To Top

RATE QUESTIONS

Q. Is this one of those policies whose cost increases as I get older?

A. No, there is one rate for each benefit level choice. Rates do not increase as you get older. Coverage ends at age 65.

Q. Do benefit amounts decrease as I get older?

A. No, they will remain the same as long as your policy is in force.

Q. Can the coverage amount be changed?

A. Coverage amounts can be changed anytime by calling 1-800-393-0864 or by downloading a coverage change form.

Q. Can the coverage be paid by credit card?

A. Yes, members who apply will have various payment options when they receive their policies.

Q. Is the automatic checking account deduction available?

A. Yes.

Return To Top