As a member and part of the United Business Association group, you have access to enhance your membership and add a plan that includes supplemental group insurance like accident, critical illness or hospital indemnity that have been issued to the United Business Association. UBA's optional supplemental plus plans category includes group and blanket group insurance from United States Fire Insurance Company, SiriusPoint America Insurance Company, Windsor Life Insurance Company, and Guaranteed Trust Life Insurance Company. All plans in this category also include the non-insurance Benefit Boost 1.0 Subscription services. View more about UBA's optional supplemental plus plans: GAP AME 10K+ PLAN underwritten by Guarantee Trust Life Insurance Company, UBA ACCIDENT+ underwritten by SiriusPoint America Insurance Company, GAP CI 25K+ underwritten by Windsor Life Insurance Company, GAP 5000+ underwritten by SiriusPoint America Insurance Company, GAP+ underwritten by United States Fire Insurance Company, GAP EDGE+ underwritten by SiriusPoint America Insurance Company, and GAP5+ underwritten by Guarantee Trust Life Insurance Company. (Select the name or scroll below.)
If you are looking for simple Accident Only Coverage with the added benefits of Benefit Boost, Gap AME 10K+ might be the right plan to add to your UBA Membership. Gap AME 10K+ offers valuable coverage for families, people who tend to be accident-prone or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident or injury along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap AME 10K+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap plan helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by Guaranteed Trust Life Insurance Company (GTL)
AL, AZ, AR, CA, CT, DC, DE, FL, GA, IL, IN, IA, KS, KY, MI, MS, NC, ND, NE, NV, OH, OK, PA, RI, SC, TN, TX, VA, WV, WI & WY
$50 - Ind | $90 - Ind+1 | $120 - Family
*The plan cost for the optional supplemental Gap AME 10K+ plan does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Group Accident Medical Expense Insurance
$10,000 Group Accident Medical Expense Benefit Maximum Benefit per injury.
$100 Deductible per injury.
Covered Services (as defined by policy) & Maximum Benefit:
Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company (GTL).
Group Accidental Death & Dismemberment Insurance
$1,000 Accidental Death & Dismemberment Benefit Principal Sum
Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company.
Along with the group insurance coverage provided in Gap AME 10K+, the non-insurance UBA Membership Benefits provided by the United Business Association include 24-Hr Nurse Helpline, Lab Discounts, Discount Hearing Service, Safelite AutoGlass Discount, UBA Savings Perks Program and more. For full description of the UBA Membership non-insurance benefits and services, review the sample membership guide.
Guarantee Trust Life Insurance does not offer and is not affiliated with the non-insurance services and discount programs offered in connection with membership in the United Business Association (UBA).
ASSOCIATION MEMBERSHIP BENEFITS
PROVIDED BY:
GROUP ACCIDENT INSURANCE ONLY INSURANCE
UNDERWRITTEN BY:
Guarantee Trust Life Insurance Company
BILLING*, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance.
Accident Medical Expense and Accidental Death & Dismemberment Benefits are offered under Group Accident Only insurance issued on Policy form series MP-1300/MP-1400, Certificate form series GC-1300/GC-1400, by Guarantee Trust Life insurance Company (GTL), Glenview, IL. The policy is issued to the United Business Association (UBA) and includes the following: exclusions, limitations, reductions of benefits, and terms of renewal and termination. Subject to state availability, variability, and GTL’s right to increase premium rates.
Cancellation / Termination of Benefits/Renewability: Coverage terminates when UBA terminates the policy, your membership ceases, insurance ceases for your class, for non-payment of premium by UBA, or the date of fraud or misrepresentation of a material fact. The group policy terminates for non-payment of premium, if group participation requirements are not met or on any premium due date for any of the following reasons: fraud or misrepresentation of a material fact; failure of UBA to provide required information; or at GTL's option with 30 days notice. Notice of termination provided to UBA is considered notice of termination to all members and will not be sent to you individually by GTL. The policy automatically renews each policy anniversary until cancellation/termination.
GTL does not provide nor is affiliated with the discount programs provided as part of membership in UBA.
The insurance described above provides limited benefits. Limited benefit policies are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. This insurance is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, this insurance is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act.
The following monthly insurance rates apply to coverage underwritten by Guarantee Trust Life Insurance Company. Your overall total association membership dues also include these insurance rates: Individual = $7.75; Family = $19.37.
As part of your overall Gap AME 10K+ plan cost, the non-insurance Benefit Boost services retail at $25 (Individual), $40 (Ind+1), and $60 (Family). Guarantee Trust Life Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA). Plan cost does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
If there are any discrepancies between this description and the Certificate, the Certificate will govern.
AAD101.15-19
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost 1.0 Subscription Services which are:
All Benefit Boost 1.0 Services are not Insurance and are separate services from the insurance as part of this optional membership plan. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap AME 10K+ plan cost, the non-insurance Benefit Boost 1.0 Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription 1.0 Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Guarantee Trust Life Insurance Company(GTL) does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealthyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
UBA Accident+ is supplemental insurance for accidents which can help be an extra layer of protection for some out-of-pocket medical costs when accidents occur (subject to policy & certificate of insurance terms, conditions, limitations & exclusions). UBA Accident+ is underwritten by SiriusPoint America Insurance Company. UBA Accident+ also includes the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. UBA Accident+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership plan helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by SiriusPoint America Insurance Company
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY
$40 - Ind | $60 - Ind+1 | $90 - Family
*The membership plan cost for UBA Accident+ does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Blanket Group Accident Medical Expense Insurance
$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Blanket Group Accidental Death & Dismemberment Insurance
$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Blanket Group Accident Insurance Policy is underwritten by SiriusPoint America Insurance Company.
ASSOCIATION BENEFITS
PROVIDED BY:
BLANKET GROUP ACCIDENT INSURANCE POLICIES UNDERWRITTEN BY:
SiriusPoint America Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by SiriusPoint America Insurance Company1. Your overall total association membership dues for the optional supplemental UBA Accident+ plan also include these monthly insurance rates:
1Blanket Group Accident Insurance:
$8.54 (Member), $17.07 (Member+1), $32.18 (Family)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership plans and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Group Accident Insurance is underwritten by SiriusPoint America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Membership plan cost for UBA Accident+ does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, SiriusPoint America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
If there are any discrepancies between this description and the Certificate, the Certificate will govern.
HASA-BAM-1000
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost 1.0 Subscription Services which are:
All Benefit Boost 1.0 Services are not Insurance and are separate services from the insurance as part of this optional membership plan. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall UBA Accident+ plan cost, the non-insurance Benefit Boost 1.0 Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost 1.0 Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
SiriusPoint America Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealthyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care (WHVC); dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
Gap CI 25K+ is supplemental insurance that has a lump-sum benefit payment for a serious critical illness like Life-Threatening Cancer, Heart-Attack or Stroke (subject to policy & certificate of insurance definitions, terms, conditions, waiting periods, limitations & exclusions). With a lump-sum critical illness benefit, you can help pay for out-of-pocket deductibles, coinsurance, out-of-network costs, experimental treatments, travel to and from treatment, and much more. Gap CI 25K+ is underwritten by Windsor Life Insurance Company. Gap CI 25K+ also includes the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap CI 25K+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership plan helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by Windsor Life Insurance Company
AR, AZ, MO, MS, OK, & TX
$30 - Ind | $60 - Ind+Sp
*The membership plan cost for Gap CI 25K+ does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Critical Illness Insurance Benefit
$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $2500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date.
Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
(The covered member must meet all requirements listed in the definition and outlined in the Certificate of Insurance for the covered Critical Illness to qualify. Only one lump-sum benefit is eligible per covered member and is only available upon the first diagnosis of one covered Critical Illness. Once a lump-sum payment has been issued to a covered member, coverage for that member ends.)
Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company.
ASSOCIATION BENEFITS
PROVIDED BY:
GROUP CRITICAL ILLNESS INSURANCE POLICIES UNDERWRITTEN BY:
Windsor Life Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by Windsor Life Insurance Company1. Your overall total association membership dues for the optional supplemental Gap CI 25K+ plan also include these monthly insurance rates:
1Group Critical Illness Insurance:
$10.00 (Member), $20.00 (Member+Spouse)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership plans and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company, Dallas, TX. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Membership plan cost for Gap CI 25K+ does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, Windsor Life Insurance Company, Optimum Re Life Reinsurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
If there are any discrepancies between this description and the Certificate, the Certificate will govern.
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost 1.0 Subscription Services which are:
All Benefit Boost 1.0 Services are not Insurance and are separate services from the insurance as part of this optional membership plan. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap CI 25K+ plan cost, the non-insurance Benefit Boost 1.0 Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost 1.0 Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Windsor Life Insurance Company and Optium Re Life Reinsurance Company do not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealthyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care (WHVC); dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
Along with the long-established services available with your UBA Membership, Gap 5000+, underwritten by SiriusPoint America Insurance Company, offers an extra layer of protection to offset some out-of-pocket medical costs due to an accident or being diagnosed with a covered critical illness for the first time (subject to policy & certificate of insurance terms, conditions, limitations & exclusions). This plan is perfect for those that are accident prone or who have a family history of heart attack, cancer or stroke. Gap 5000+ also includes the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap 5000+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership plan helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by SiriusPoint America Insurance Company
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY
$30 - Ind | $50 - Ind+1 | $70 - Family
*The membership plan cost for Gap 5000+ does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Blanket Group Accident Medical Expense Insurance
$5,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Blanket Group Accidental Death & Dismemberment Insurance
$2,500 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Blanket Group Accident Insurance is underwritten by SiriusPoint America Insurance Company.
Critical Illness Insurance Benefit
$5,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $1000 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
Group Critical Illness Insurance is underwritten by SiriusPoint America Insurance Company.
ASSOCIATION BENEFITS
PROVIDED BY:
BLANKET GROUP ACCIDENT INSURANCE
& GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
SiriusPoint America Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by SiriusPoint America Insurance Company1. Your overall total association membership dues for the optional supplemental Gap 5000+ plan also include these monthly insurance rates:
1Blanket Group Accident Insurance:
$4.17 (Member), $8.37 (Member+1), $15.76 (Family)
1Group Critical Illness Insurance:
$3.26 (Member) & $6.51 (Member+Spouse)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Group Accident Insurance and Group Critical Illness Insurance are underwritten by SiriusPoint America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Group Critical Illness Insurance Benefit Maximum is reduced if the first diagnosis occurs in the first year from the effective date. Membership plan cost for Gap 5000+ does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, SiriusPoint America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
If there are any discrepancies between this description and the Certificate, the Certificate will govern.
HASA-1000 | HASA-BAM-1000
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost 1.0 Subscription Services which are:
All Benefit Boost 1.0 Services are not Insurance and are separate services from the insurance as part of this optional membership plan. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap 5000+ plan cost, the non-insurance Benefit Boost 1.0 Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost 1.0 Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
SiriusPoint America Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealthyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
Gap+ with insurance underwritten by United States Fire Insurance Company, helps to bridge the gap for some unexpected out-of-pocket medical expenses due to an accident or being diagnosed with a covered critical illness for the first time (subject to policy & certificate of insurance terms, conditions, limitations & exclusions). But in addition to coverage for accidents or critical illness, Gap+ also includes a group hospital fixed indemnity insurance doctor visit benefit, laboratory testing benefit & x-ray/radiology benefit (coverage may vary or may not be available in all states). In addition to the insurance benefits provided by United States Fire Insurance Company, Gap+ includes the highly regarded non-insurance Benefit Boost services like Walmart Health Virtual Care Visits (Virtual Urgent Care & Talk Therapy Visits), free vitamins and more. Gap+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership plan helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by United States Fire Insurance Company
AL, AR, AZ, DC, DE, FL, GA, IL, IN, IA, KY, LA, MI, MS, NE, NC, ND, OH, OK, RI, SC, TN, TX, VA, WV, WI, & WY
$40 - Ind | $60 - Ind+1 | $80 - Family
*The membership plan cost for Gap+ does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance. The breakdown of the group insurance costs are located in the Brief Group Insurance Description tab and the non-insurance costs are located in the Non-Insurance Benefit Boost Services tab.
Group Accident Medical Expense Insurance
$5,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Group Accidental Death & Dismemberment Insurance
$2,500 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Group Accident Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states. If there are any discrepancies between this description and the Certificate, the Certificate will govern.
Daily Hospital Confinement Benefit
$500 Daily Hospital Confinement Benefit
Days 1-3 for hospital confinement in a policy period
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states. If there are any discrepancies between this description and the Certificate, the Certificate will govern.
Daily Physician Office Visit Benefit
$125 per day Daily Physician Office Visit Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.
Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states. If there are any discrepancies between this description and the Certificate, the Certificate will govern.
Daily Outpatient Diagnostic Radiology & X-Ray Benefit
$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.
Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states. If there are any discrepancies between this description and the Certificate, the Certificate will govern.
Daily Outpatient Diagnostic Laboratory Tests Benefit
$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.
Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states. If there are any discrepancies between this description and the Certificate, the Certificate will govern.
Critical Illness Insurance Benefit
$5,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
Critical Illness Insurance Benefit is a rider to the Group Hospital Fixed Indemnity Insurance which is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states. If there are any discrepancies between this description and the Certificate, the Certificate will govern.
ASSOCIATION BENEFITS
PROVIDED BY:
GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
CRITICAL ILLNESS INSURANCE BENEFIT RIDER
UNDERWRITTEN BY:
United States Fire Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company1. Your overall total association membership dues for the optional supplemental Gap+ plan also include these monthly insurance rates
1Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
1Group Hospital Fixed Indemnity Insurance:
$7.98 (Individual), $15.66 (Ind+1), $19.90 (Family)
1Critical Illness Insurance Benefit Rider:
$3.00 (Individual), $6.00 (Ind+1), $6.00 (Family)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance which also includes the Critical Illness Insurance Benefit Rider is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Membership plan cost for Gap+ does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, Crum & Forster, United States Fire Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
If there are any discrepancies between this description and the Certificate, the Certificate will govern.
2891685
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost 1.0 Subscription Services which are:
All Benefit Boost 1.0 Services are not Insurance and are separate services from the insurance as part of this optional membership plan. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap+ plan cost, the non-insurance Benefit Boost 1.0 Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost 1.0 Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Crum & Forster and United States Fire Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealthyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
Along with the long-established services available with your UBA Membership, Gap Edge+, underwritten by SiriusPoint America Insurance Company offers an extra layer of protection to offset some out-of-pocket medical costs due to an accident or being diagnosed with a covered critical illness for the first time (subject to policy & certificate of insurance terms, conditions, limitations & exclusions) and coverage for doctor, urgent care & emergency room visits. This membership plan combines the Gap 25000 and Complement Care Membership plans into one convenient package. Gap Edge+ also includes the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap Edge+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership plan helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by SiriusPoint America Insurance Company
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS,
NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
$65 - Ind | $125 - Ind+1 | $190 - Family
*The membership plan cost for Gap Edge+ does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Blanket Group Accident Medical Expense Insurance
$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Blanket Group Accidental Death & Dismemberment Insurance
$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Blanket Group Accident Insurance Policy is underwritten by SiriusPoint America Insurance Company.
Critical Illness Insurance Benefit
$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $2500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
Group Critical Illness Insurance Policy is underwritten by SiriusPoint America Insurance Company.
Physician Visit and Urgent Care Visit Benefit
$125 per visit up to 4 visits per Covered Person per Coverage Year.
A daily benefit will be paid for each visit made by a Covered Person to a Physician's Office or a licensed Urgent Care Facility to receive care or treatment of a Sickness, an Accident or an Injury.
Member and Dependent coverage ends when the Member is age 65.
Emergency Room Visit Benefit
$500 per visit up to 2 visits per Covered Person per Coverage Year.
A daily benefit will be paid for a Physician's treatment of a Covered Person during an Emergency Room visit during which Emergency Care is provided for Sickness, Accident or Injury.
Member and Dependent coverage ends when the Member is age 65.
Pre-existing Condition Limitation
The Policy will not cover any loss due to a Pre-existing Condition if the loss begins within 12 months after the Covered Person's effective date of insurance. However, the Policy may pay benefits for a loss due to a Pre-existing Condition of a Covered Person who was covered:
1. by a Replaced Policy; and
2. by the Policy, issued by Us to the Policyholder on the Policy Effective Date, and the Certificate.
The claim will be reviewed. If the Pre-Existing Condition Limitation in the Certificate does not apply, the benefits provided by the Policy and the Certificate will be paid.
If the Covered Person does not satisfy the Certificate's Pre-existing Condition Limitation, but can satisfy the Replaced Policy's pre-existing condition limitation giving credit for all time insured under both policies; then the benefit payable will be the lesser of:
1. the benefits provided by the Policy and the Certificate without applying the Pre-existing Condition Exclusion; or
2. the benefits provided by the Replaced Policy.
If the Covered Person does not satisfy the Certificate's Pre-existing Condition Limitation or that of the Replaced Policy, no Benefit will be paid.
CO's Pre-existing Condition Limitation differs from what is listed above. Please view the state Certificate in the Certificate of Insurance (Limitations & Exclusions) tab to view CO's Pre-existing Condition Limitation.
Definition of Pre-existing Condition:
Pre-existing condition means a condition for which a Physician has treated or for which a Physician has advised treatment of the Covered Person within 12 months before the Covered person's effective date of insurance.
In AL, AR, AZ, DC, DE, GA, IL, IN, KY, LA, MS, NE, OH, OK, RI, TN, VA, WI & WV the definition adds the following to the definition above: It is also one which would cause a person to seek diagnosis or care within the same 12-month period.
CO, MO, NV & WY all have a different definition than above based on the Certificate of Insurance. View the Certificate in the Certificates of Insurance (Limitations & Exclusions) tab to view those state definitions of Pre-existing Condition.
Coverage Year:
Means a period beginning on the Primary Covered Person's Certificate Effective Date and ending 12 months after that date. Successive Coverage Years will begin after the first Coverage Year, each extending for 12-Month periods, provided that the Primary Covered Person does not terminate His coverage within the same Coverage Year. If the Primary Covered Person terminates His coverage during a Coverage Year and re-enrolls for coverage under a new certificate within the same Coverage Year, all benefits, benefit limits and benefit maximums will be those that applied to Him under the previously terminated certificate. In this case, a new Coverage Year will begin for the Primary Covered Person after He has been insured under the new certificate of a period of 12 months.
Group Hospital Indemnity Insurance Policy is underwritten by SiriusPoint America Insurance Company.
ASSOCIATION BENEFITS
PROVIDED BY:
BLANKET GROUP ACCIDENT INSURANCE
& GROUP CRITICAL ILLNESS INSURANCE
& GROUP HOSPITAL INDEMNITY INSURANCE
POLICIES UNDERWRITTEN BY:
SiriusPoint America Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by SiriusPoint America Insurance Company1. Your overall total association membership dues for the optional supplemental Gap Edge+ plan also include these monthly insurance rates:
1Blanket Group Accident Insurance:
$8.54 (Member), $17.07 (Member+1), $32.18 (Family)
1Group Critical Illness Insurance:
$15.45 (Member) & $30.90 (Member+Spouse)
1Group Hospital Indemnity Insurance:
$10.85 (Member), $23.44 (Member+1), $36.73 (Family)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Group Accident Insurance, Group Critical Illness Insurance, and Group Hospital Indemnity Insurance Policies are underwritten by SiriusPoint America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Group Critical Illness Insurance Benefit Maximum is reduced if the first diagnosis occurs in the first year from the effective date (see Schedule of Benefits). Coverage for Group Hospital Indemnity Insurance is for member and eligible spouse between the ages of 18-64, and their enrolled dependent children. Benefit for Group Hospital Indemnity Insurance ends at age 65. Membership plan cost for Gap Edge+ does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, SiriusPoint America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
If there are any discrepancies between this description and the Certificate, the Certificate will govern.
HASA-1000 | HASA-BAM-1000 | HASA-HI-1000
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost 1.0 Subscription Services which are:
All Benefit Boost 1.0 Services are not Insurance and are separate services from the insurance as part of this optional membership plan. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall GAP EDGE+ plan cost, the non-insurance Benefit Boost 1.0 Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost 1.0 Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
SiriusPoint America Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealthyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
With Group Accident, Cancer Lump Sum Benefit Rider, Limited Specified Disease Benefit Rider providing benefits for Heart Attack and Stroke, Sickness Lump Sum Hospital Benefit Rider and Group Term Life Insurance, Gap5+ might be the right plan to add to your UBA Membership. Gap5+ offers valuable coverage for families, people who tend to be accident-prone or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident or injury, critical illness, hospital stay or term life along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap5+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap plan helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by Guaranteed Trust Life Insurance Company (GTL)
AL, AR, AZ, DC, DE, GA, IA, IL, LA, MS,
NE, OH, OK, SC, TX, VA, WI, WV, & WY
$70 - Ind | $140 - Ind+1 and Family
*The plan cost for the optional supplemental Gap5+ plan does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Group Accident Medical Expense Insurance
$5,000 Group Accident Medical Expense Benefit Maximum Benefit per injury.
$100 Deductible per injury.
Covered Services (as defined by policy) & Maximum Benefit:
Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company (GTL).
Group Accidental Death & Dismemberment Insurance
$2,500 Principal Sum - Accidental Death & Dismemberment, Loss of Sight, Speech and Hearing Benefit
Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company.
Cancer Lump Sum Benefit Rider
$5,000 Maximum Benefit Amount
60 day waiting period
Benefits for the Cancer Lump Sum Benefit Rider if the Covered Person is Diagnosed with Cancer after the Rider's effective date of coverage and while the Rider is in force, subject to the Waiting Period, if any. Benefits under this provision are limited to one (1) First Diagnosis Lump Sum Benefit payment per Covered Person's lifetime.
Pre-existing conditions apply. Please read Certificate of Insurance & Cancer Lump Sum Benefit Rider for all state-specific schedule of benefits, terms, conditions, limitations, exclusions, and provisions.
Must be under age 60 to apply and enroll. Coverage eligibility applies all members under age 60. Coverage for both Covered Person and Eligible Dependent Spouse ends at age 65. Dependent Child coverage ends at age 26 or otherwise defined in the Certificate and Rider.
Group Accident Only Insurance and the Cancer Lump Sum Benefit Rider is underwritten by Guarantee Trust Life Insurance Company.
Limited Specified Disease Benefit Rider
Providing benefits for Heart Attack and Stroke
$5,000 Maximum Benefit Amount
60 day waiting period
After the waiting period, if any, has been satisfied and while the Policy and this Rider are in force for the Covered Person, benefits will be paid for the Lum Sum Benefit Amount shown in the Schedule upon the diagnosis of a Covered Condition. If more than one qualifying Covered Condition occurs or procedure is performed under the Additional Benefit provision, a benefit will only be provided for the first Covered Condition or Additional Benefit that is eligible for benefits. A benefit will not be provided for multiple conditions.
Pre-existing conditions apply. Please read Certificate of Insurance & Limited Specified Disease Benefit Rider for all state-specific schedule of benefits, terms, conditions, limitations, exclusions, and provisions.
Must be under age 60 to apply and enroll. Coverage eligibility applies all members under age 60. Coverage for both Covered Person and Eligible Dependent Spouse ends at age 65. Dependent Child coverage ends at age 26 or otherwise defined in the Certificate and Rider.
Group Accident Only Insurance and the Limited Specified Disease Benefit Rider is underwritten by Guarantee Trust Life Insurance Company.
Sickness Lump Sum Hospital Benefit Rider
$2,500 per Hospital Confinement Lump Sum Hospital Benefit Amount
Lump Sum Hospital Benefit Amount:
30 day Lump Sum Hospital Benefit Waiting Period
Maximum Calendar Year Benefit - One Hospital Confinement
Benefits will be paid for the Sickness Lump Sum Hospital Benefit when a Covered Person is Hospital Confined as an inpatient for a Covered Sickness. Benefits are payable only when a Covered Sickness is incurred by a Covered Person while his or her coverage under the Policy and the Rider is in force; the waiting period, if any has been satisfied; and is not otherwise excluded from coverage under the Policy and Rider. Unless specified otherwise, benefits and their limits are per Calendar Year, per Covered Person.
Pre-existing conditions apply. Please read Certificate of Insurance & Sickness Lump Sum Hospital Benefit Rider for all state-specific schedule of benefits, terms, conditions, limitations, exclusions, and provisions.
Must be under age 60 to apply and enroll. Coverage eligibility applies all members under age 60. Coverage for both Covered Person and Eligible Dependent Spouse ends at age 65. Dependent Child coverage ends at age 26 or otherwise defined in the Certificate and Rider.
Group Accident Only Insurance and the Sickness Lump Sum Hospital Benefit Rider is underwritten by Guarantee Trust Life Insurance Company.
$10,000 Death Benefit - Primary Member
Subject to Waiting Period & Attained Age Benefit Reduction.
Group Term Life Insurance
If, within 90 days from the date of an Accident which occurs while coverage is in force, Injury from such Accident results in a loss covered by this benefit. The Death Benefit will be paid in the amount set opposite such loss, as shown in the Schedule of Benefits. If more than one such loss is sustained as the result of one Accident, only one amount will be paid, the largest to which the Covered Person is entitled.
Group Term life Insurance with Accidental Death Benefit Coverage Amounts for Primary Member
AGES 18-64
Waiting Period (6 Months):
$10,000 Accidental Death Benefit Only
Ongoing Coverage (Beyond Waiting Period):
$10,000 Term Life Benefit
AGES 65-69
Waiting Period (6 Months):
$10,000 Accidental Death Benefit Only
Ongoing Coverage (Beyond Waiting Period):
$5,000 Term Life Benefit + $5,000 Accidental Death Benefit
AGES 70+
$10,000 Accidental Death Benefit Only
During the first 6 months that your benefit enrollment is active, waiting period benefits are limited to $10,000 of Accident Death Benefits only. After 6 months of continuous benefit enrollment, benefits are provided based on your attained age as reflected in the benefit tiers shown above.
Spousal Benefits are 50% of the Primary Member's term life insurance benefit, subject to the waiting period and attained age benefit tiers shown above. Child benefits are 25% of the Primary Member's term life insurance benefit.
Group Term Life Insurance is underwritten by Guarantee Trust Life Insurance Company ("GTL").
This Benefit is subject to all terms, conditions and exclusions of the Certificate of Insurance.
Suicide Exclusion
If a Covered Person dies as the result of suicide or any attempt at suicide, while sane or insane within two years of his Effective Date of coverage, the insurance company will be liable only for an amount equal to the Premium paid.
With respect to an increase in the amount of insurance, the insurance company will consider the two year period to begin as of the effective date of such increase.
The return of such Premium will be in lieu of all other benefits under the Certificate which may have been payable for that Covered Person.
Along with the group insurance coverage provided in Gap5+, the non-insurance UBA Membership Benefits provided by the United Business Association include 24-Hr Nurse Helpline, Lab Discounts, Discount Hearing Service, Safelite AutoGlass Discount, UBA Savings Perks Program and more. For full description of the UBA Membership non-insurance benefits and services, review the sample membership guide.
Guarantee Trust Life Insurance does not offer and is not affiliated with the non-insurance services and discount programs offered in connection with membership in the United Business Association (UBA).
ASSOCIATION MEMBERSHIP BENEFITS
PROVIDED BY:
GROUP ACCIDENT INSURANCE ONLY INSURANCE
CANCER LUMP SUM BENEFIT RIDER
LIMITED SPECIFIED DISEASE BENEFIT RIDER
SICKNESS LUMP SUM HOSPITAL BENEFIT RIDER
& GROUP TERM LIFE INSURANCE
ARE UNDERWRITTEN BY:
Guarantee Trust Life Insurance Company
BILLING*, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance.
The Accident Medical Expense and Accidental Death & Dismemberment Benefits are offered under Group Accident Only Insurance issued on Policy form series MP-1400, Certificate form series GC-1400 and underwritten by Guarantee Trust Life insurance Company (GTL), Glenview, IL. The Cancer Lump Sum Benefit, Limited Specified Disease Benefit for Heart Attack and Stroke, and Sickness Lump Sum Hospital Benefit are offered as riders to the policy under form series GRG15CR, GRG15HAS, GR15SHI. Group Term Life Insurance is issued on Policy/Certificate Form Series GLMP-3002/GLC-3002. The policies are issued to the United Business Association (UBA) and includes the following: exclusions, limitations, reductions of benefits, and terms of renewal and termination. Subject to state availability, variability, and GTL's right to increase premium rates.
Cancellation / Termination of Benefits/Renewability: Coverage terminates when UBA terminates the policy, your membership ceases, insurance ceases for your class, for non-payment of premium by UBA, or the date of fraud or misrepresentation of a material fact. The group policy terminates for non-payment of premium, if group participation requirements are not met or on any premium due date for any of the following reasons: fraud or misrepresentation of a material fact; failure of UBA to provide required information; or at GTL's option with 30 days notice. Notice of termination provided to UBA is considered notice of termination to all members and will not be sent to you individually by GTL. The policy automatically renews each policy anniversary until cancellation/termination.
GTL does not provide nor is affiliated with the discount programs provided as part of membership in UBA.
The insurance described above provides limited benefits. Limited benefit policies are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. This insurance is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, this insurance is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act.
The following monthly insurance rates apply to coverage underwritten by Guarantee Trust Life Insurance Company. Your overall total association membership dues also include these insurance rates for the Group Accident Only Insurance, Cancer Lump Sum Benefit Rider, Limited Specified Disease Benefit Rider and the Sickness Lump Sum Hospital Benefit Rider: Individual = $29.49; Family = $68.24 and for the Group Term Life Insurance: $4.40.
As part of your overall Gap5+ plan cost, the non-insurance Benefit Boost 1.0 services retail at $25 (Individual), $40 (Ind+1), and $60 (Family). Guarantee Trust Life Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost 1.0 services and discount programs offered in connection with membership in the United Business Association (UBA). Plan cost does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
If there are any discrepancies between this description and the Certificate and Riders, the Certificate and Riders will govern.
AAD101.15-19
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost 1.0 Subscription Services which are:
All Benefit Boost 1.0 Services are not Insurance and are separate services from the insurance as part of this optional membership plan. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap5+ plan cost, the non-insurance Benefit Boost 1.0 Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost 1.0 Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Guarantee Trust Life Insurance Company(GTL) does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealthyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
United Business Association, Crum & Forster, United States Fire Insurance Company, SiriusPoint America Insurance Company, Guarantee Trust Life Insurance Company, Windsor Life Insurance Company, Optimum Re Life Reinsurance Company, Walmart Health Virtual Care, MeMD, Paramount RX®, Aetna Dental Access®, LifeLock®, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
2891685 | AAD101-15.19 | HASA-1000 | HASA-BAM-1000 | HASA-HI-1000
United Business Association does not require members to enroll or purchase any group or blanket group insurance to become a member of UBA. The optional association group insurance is only available to members of UBA who have the desire to enhance their membership. All group association insurance offered through UBA is supplemental and does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage available is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Membership includes multiple non-insurance services and benefits, including access to insurance products.
Healthy America Insurance Agency Inc. is the exclusive marketer for the United Business Association and Healthy America Association.
Agency CA License 0G32190
