Accident

Jim Ellis offers an accident plan through Voya Financial to protect you from unexpected non-occupational accidents, as it can be difficult to financially plan for the unexpected.  This plan provides a benefit payable according to a schedule, and the funds may be used for any purposes, including helping to pay for medical out-of-pocket costs like deductibles and coinsurance.  The expenses must result from a non-occupational / non-work related accidental injury. 

 

Important Documents

This plan reimburses you for your medical expenses according to the schedule and the benefit is paid directly to you. Coverage options are available for you, your spouse, and your dependent child(ren). It also includes a benefit for death, loss of limbs, hospital visits, and transportation by ambulance – as a result of a covered accident. Reference the plan summary below for more details.

Injury Benefit
Hospital Care
Surgery - Open abdominal, thoracic $1,000
Blood $500
Admission $1,125
Confinement $350 / day up to 365 days
Transportation $650 / trip up to 3 per accident
Lodging $150 / day up to 30 days
Accident Care
Initial doctor visit $75
Urgent care $200
Follow-up doctor treatment $75
Medical equipment $100
Speech & physical therapy $40 up to 6 per accident
X-Ray $40
Common Injuries
Burns: 2nd and 3rd degree $1,125 to $12,500
Emergency dental work $75 to $300
Eye injury $80 to $275
Torn knee cartilage $175 to $650
Lacerations $25 to $400
Tendon, ligament, rotator cuff $350 to $1,000
Concussion $175
Paralysis $13,500 to $20,000
Injuries - Dislocations
Non-surgical | Surgical
Hip joint $3,200 | $6,400
Knee $2,000 | $4,000
Ankle or foot bones (other than toes) $1,200 | $2,400
Shoulder $1,500 | $3,000
Elbow, wrist $900 | $1,800
Finger / Toe $250 | $500
Hand bones (other than fingers), lower jaw, collarbone $900 | $1,800
Partial dislocations 25% of the non-surgical benefit
Injuries - Fractures
Non-surgical | Surgical
Hip $2,500 | $5,000
Leg $1,800 | $3,600
Ankle, hand, wrist $1,500 | $3,000
Collarbone $1,200 | $2,400
Rib(s) $350 | $750
Shoulder $1,500 | $3,000

Important Notes


  • Employee are eligible regardless of age
  • Spouses age 70 and older are not eligible to elect coverage
  • Coverage for eligible child dependent(s) is up to age 26

Reminder of Additional Coverage


Employees and covered dependents enrolled in the Navigate HMO HSA and the Navigate HMO medical plans will receive a limited accident benefit according to a benefits schedule at no cost. For example, the bundled accident plan provides $1,950 for a hip dislocation (compared to $3,200 for the voluntary plan). The bundled accident plan provides $1,500 for a hip fracture (compared to $2,500 for the voluntary
plan.)

Employees enrolled in the Navigate HMO HSA and HMO plans may also elect voluntary accident to supplement the basic accident benefit.

Sports Accident Coverage


The Voya Accident plan pays an additional 25% of the Hospital Care, Accident Care, and Common Injuries benefits to a maximum of $1,000 if the covered accident is as a result of an organized       sporting activity.

Exclusions


All sicknesses including pregnancy, work-related injuries, services not medically necessary, being intoxicated in accordance with state laws, alcoholism, voluntary inhalation of gas/fumes/taking of poison, driving in any race or speed test or while testing an automobile or vehicle on any racetracks or speedway, injury while skydiving, hang gliding, parachuting, scuba diving, rodeo, or aviation except flight in a scheduled passenger aircraft, being under the influence of a narcotic/drug, intentionally self-inflicted injury, hernia, carpel tunnel syndrome, or any complication therefrom, bacterial infections.