Accident Insurance
ReliaStar Life Insurance Company, a member of the Voya® family of companies
A voluntary Accident Insurance plan for Uplift Education employees (Group #755541) that pays fixed benefit amounts for specific injuries and events resulting from a covered accident, including hospital care, common injuries, fractures, dislocations, accidental death and dismemberment, and catastrophic accident benefits.
Accident Insurance pays you benefits for specific injuries and events resulting from a covered accident. Accident Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.
You have the option to enroll yourself as well as your spouse and children in Accident Insurance coverage to meet your needs. Employees must be enrolled in order to elect coverage for eligible spouse and eligible dependent children as defined in the Certificate of Coverage and Riders.
Accident Hospital Care
| Benefit | Benefit Amount |
|---|---|
| Accident Hospital Care | |
| Surgery (open abdominal, thoracic) | $2,500 |
| Surgery (exploratory or without repair) | $350 |
| Blood, Plasma, Platelets | $650 |
| Hospital Admission | $2,000 |
|
Hospital Confinement Per day, up to 365 days |
$400 |
| Critical Care Unit (CCU) Admission | $4,000 |
|
Critical Care Unit Confinement Per day, up to 30 days |
$800 |
|
Rehabilitation Facility Confinement Per day, up to 90 days |
$250 |
|
Induced Coma Up to 14 days |
$250 |
|
Non-Induced Coma Duration of 14 or more days |
$20,000 |
|
Transportation Per trip, up to 3 per accident |
$850 |
|
Lodging Per day, up to 30 days |
$225 |
| Pet Boarding | $25 |
|
Family Care Per child/adult, up to 45 days |
$40 |
Accident Care
| Benefit | Benefit Amount |
|---|---|
| Accident Care | |
| Initial Doctor Visit | $150 |
| Urgent Care Facility Treatment | $300 |
| Emergency Room Treatment | $350 |
| Ground Ambulance | $600 |
| Air Ambulance | $2,500 |
| Follow-up Doctor Treatment | $150 |
|
Chiropractic Treatment Up to 6 per accident |
$75 |
| Prescription Medicine | $20 |
| Medical Equipment | $500 |
|
Physical or Occupational Therapy Per treatment, up to 10 |
$75 |
|
Speech Therapy Per treatment, up to 10 |
$75 |
|
Mental Health Therapy Per treatment, up to 10 |
$75 |
| Prosthetic Device (one) | $1,500 |
| Prosthetic Device (two or more) | $2,400 |
| Major Diagnostic Exams (CT/CAT scan, MRI, EEG, PET scan, Ultrasound) | $500 |
| Outpatient Surgery | $300 |
| X-ray | $100 |
Common Injuries
| Benefit | Benefit Amount |
|---|---|
| Burns | |
| Burns (2nd degree, at least 36% of body) | $1,750 |
| Burns (3rd degree, at least 2% but less than 4% of total body surface area) | $10,000 |
| Burns (3rd degree, 4% or more of total body surface area) | $22,000 |
| Skin Grafts | 50% of burn benefit |
| Dental & Eye | |
| Emergency Dental Work (Crown) | $480 |
| Emergency Dental Work (Extraction) | $180 |
| Eye Injury (removal of foreign object) | $400 |
| Eye Injury (surgery) | $420 |
| Cartilage & Soft Tissue | |
| Torn Hip, Knee or Shoulder Cartilage (surgery with no repair or if cartilage is shaved) | $280 |
| Torn Hip, Knee or Shoulder Cartilage (surgical repair) | $1,000 |
| Lacerations & Wounds | |
|
Laceration (treated - no sutures) Total of all lacerations per accident; payable once per covered accident |
$60 |
|
Laceration (sutures up to 2") Total of all lacerations per accident; payable once per covered accident |
$120 |
|
Laceration (sutures 2" to 6") Total of all lacerations per accident; payable once per covered accident |
$480 |
|
Laceration (sutures over 6") Total of all lacerations per accident; payable once per covered accident |
$960 |
|
Puncture Wound If injury qualifies as both a laceration and puncture wound, only one benefit in the higher amount will be payable |
$75 |
| Cartilage & Soft Tissue | |
| Ruptured Disk (surgical repair) | $1,000 |
| Tendon, Ligament, Rotator Cuff (exploratory arthroscopic surgery with no repair) | $720 |
| Tendon, Ligament, Rotator Cuff (1, surgical repair) | $1,020 |
| Tendon, Ligament, Rotator Cuff (2 or more, surgical repair) | $1,520 |
| Neurological | |
| Concussion | $450 |
| Traumatic Brain Injury | $2,500 |
| Paralysis | |
| Paralysis (monoplegia) | $15,500 |
| Paralysis (hemiplegia) | $20,000 |
| Paralysis (paraplegia) | $20,000 |
| Paralysis (quadriplegia) | $30,000 |
Dislocations
| Benefit | Complete / Complete Requiring Surgical Repair |
|---|---|
| Dislocations | |
| Hip Joint | $4,000 / $8,000 |
| Knee | $2,400 / $4,800 |
| Ankle or foot bone(s) (other than toes) | $1,500 / $3,000 |
| Shoulder | $1,600 / $3,200 |
| Elbow | $1,100 / $2,200 |
| Wrist | $1,100 / $2,200 |
| Finger/toe | $275 / $550 |
| Hand bone(s) (other than fingers) | $1,100 / $2,200 |
| Lower jaw | $1,100 / $2,200 |
| Collarbone | $1,100 / $2,200 |
| Incomplete dislocations: percentage of the complete amount | 25% |
Fractures
| Benefit | Non-Surgical Repair / Fracture Requiring Surgical Repair |
|---|---|
| Fractures | |
| Hip | $5,000 / $10,000 |
| Leg | $2,500 / $5,000 |
| Ankle | $1,800 / $3,600 |
| Heel | $1,800 / $3,600 |
| Kneecap | $1,800 / $3,600 |
| Foot (excluding toes, heel) | $1,800 / $3,600 |
| Upper arm | $2,100 / $4,200 |
| Forearm, hand, wrist (except fingers) | $1,800 / $3,600 |
| Finger, Toe | $240 / $480 |
| Vertebral body | $3,360 / $6,720 |
| Vertebral processes | $1,440 / $2,880 |
| Pelvis (except coccyx) | $3,200 / $6,400 |
| Coccyx | $400 / $800 |
| Bones of the face (except nose) | $1,200 / $2,400 |
| Nose | $600 / $1,200 |
| Upper jaw | $1,500 / $3,000 |
| Lower jaw | $1,440 / $2,880 |
| Collarbone | $1,440 / $2,880 |
| Rib | $400 / $800 |
| Skull – Simple (except bones of the face) | $1,400 / $2,800 |
| Skull – Depressed (except bones of face) | $3,000 / $6,000 |
| Sternum | $360 / $720 |
| Shoulder blade | $1,800 / $3,600 |
| Chip Fractures: percentage of the Non-Surgical Repair | 25% |
Accidental Death and Dismemberment (AD&D)
| Benefit | Benefit Amount |
|---|---|
| Accidental Death — Common Carrier | |
|
Employee Common carrier: commercial transportation on regular schedule between predetermined points |
$100,000 |
|
Spouse Common carrier: commercial transportation on regular schedule between predetermined points |
$50,000 |
|
Child Common carrier: commercial transportation on regular schedule between predetermined points |
$25,000 |
| Accidental Death — Other | |
|
Employee No Accidental death benefit is payable if the Covered Person is eligible for the common carrier benefit |
$50,000 |
|
Spouse No Accidental death benefit is payable if the Covered Person is eligible for the common carrier benefit |
$25,000 |
|
Child No Accidental death benefit is payable if the Covered Person is eligible for the common carrier benefit |
$10,000 |
| Accidental Dismemberment | |
| Loss of both hands or both feet or sight in both eyes | $28,000 |
| Loss of one hand or one foot AND sight of one eye | $22,000 |
| Loss of one hand AND one foot | $22,000 |
| Loss of one hand OR one foot | $12,500 |
| Loss of two or more fingers or toes | $1,800 |
| Loss of one finger or toe | $1,250 |
Catastrophic Accident Benefits
| Benefit | Benefit Amount |
|---|---|
| Catastrophic Accident | |
| Employee | $100,000 |
| Spouse | $50,000 |
| Children | $25,000 |
|
Home Modification Benefit Payable if covered person requires modifications due to losses for which benefits are paid; modifications must be prescribed in writing by a doctor |
$2,500 |
|
Vehicle Modification Benefit Payable if covered person requires modifications due to losses for which benefits are paid; modifications must be prescribed in writing by a doctor |
$2,500 |
- Active individuals and families seeking financial protection from accidental injuries
- Employees who want a low-cost supplement to their health insurance
- 👨👩👧👦Dependents covered up to age 26
- ✅Guarantee Issue — no medical exam required
- 📋Employees must be enrolled in order to elect coverage for eligible spouse and eligible dependent children as defined in the Certificate of Coverage and Riders.
Allows you to continue your coverage under the same group policy by paying your premiums directly to the insurance company when your eligibility for benefits changes such as due to termination or reduced hours.
Allows you to maintain your current Accident Insurance coverage for yourself, your spouse and children during an employer-approved leave of absence.
Offers you and your dependents services when traveling 100 miles or more from home, including: medical assistance services, emergency medical transport services, pre-trip and cultural information, security services and accessible technology. Voya Travel Assistance services are provided by International Medical Group, Inc., Indianapolis, IN. Provisions and availability may vary by state.
- ✓ Before you enroll: Call Voya Employee Benefits Customer Service at (877) 236-7564
- ✓ After your effective date: Visit the Employee Benefits Resource Center to learn more and file a claim: presents.voya.com/EBRC/UpliftEducation
- ✓Benefits will be paid directly to you to use for any purpose, such as paying out-of-pocket medical expenses, copays, deductibles, groceries, gas, utilities and more.
- ✓Coverage is always guaranteed issue.
- ✓You can choose to take this coverage with you if you leave your employer or retire, and you'll be billed at the same rates via direct billing.
Your coverage includes a Wellness Benefit, which will pay you and covered family members an annual benefit if they complete an eligible health screening test. These screenings may include a mental health screening, flu immunization, a mammogram and a routine eye or dental exam. $50 for employees, $50 for spouses, $50 per child per calendar year.