An increasing number of brokers are offering voluntary group accident insurance to help their clients fill some of the out-of-pocket gaps that come with today’s high deductible medical plans. If you’re not already offering group accident insurance, here are four things you should know.
1. Accident, medical and disability insurance go hand-in-hand.
With employees being asked to take on greater costs with today's higher deductible medical plans, offering accident insurance coverage can be an affordable solution to help cover out-of pocket expenses in the event of an accident.
It can make a real difference because it pays a lump-sum cash benefit on top of what is paid by any other insurance. The cash payment can help cover medical deductibles and copayments, and other out-of-pocket health-related expenses.
Should an employee go out on disability as a result of the accident, accident insurance complements disability income insurance too. It can pay for everyday expenses like groceries, child care and mortgages they need to keep up with. It's a payment few employees can afford to be without.
Voluntary group accident insurance plans like Guardian's Accident Insurance can help your clients strike a balance between rising health care costs and wanting to give their employees the best possible benefits package.
2. Benefit payments depend on the type of injury and services needed during treatment and recovery.
Accident insurance helps employees handle out-of-pocket costs that add up after an accidental injury. Most accident insurance policies pay for certain types of injuries and procedures and services provided in the treatment of those injuries. This can include:
- Emergency room treatment
- Hospital stays
- Occupational or physical therapy
- Chiropractic visits
When evaluating a plan that will help your clients get the most out of their coverage, review what circumstances will pay a benefit and how extensive it is.
3. Clients can get more than just accident insurance
Voluntary group accident insurance is not a standardized product. What's included with accident insurance policies can vary from one company to the next. Below are some standard features available on all Guardian Accident Insurance plans.
Our Rainy Day Fund pays benefits when a covered person has exhausted a frequency limitation on many benefits. Members start each year with up to $500 in the fund (varies based on the plan design chosen by employer) and we use that money to pay claims that would otherwise be denied due to frequency limitations. Leftover amounts up to half of the initial fund amount are rolled over to the next year. Uses for the Rainy Day Fund include doctor follow-up visits, fractures, outpatient therapies, and many more.
TravelAid Services are also included providing employees and their dependents with a safety net for both personal and business travel. TravelAid is available around the clock and the world to ensure assistance when members need help the most – whether it’s a medical emergency or simply replacing travel documents.
The following riders* can be added to a Guardian Accident Insurance plan for even greater coverage:
- Injury-Free BenefitTM. Members are paid a benefit when their family remains claim-free for five years. We pay the benefit even if there are Wellness and/or Concussion Baseline Study claims. No other carrier offers this type of planholder rider.
- Automatic Increase Option. Provides an automatic 5% increase in benefits every year for a maximum of five years with no increase in employee premium. Does not apply to: disability, hospital confinement due to sickness, and wellness benefit.
- Wellness rider. Employees can receive a wellness benefit payment of $50 - $150 per year when they complete certain routine wellness procedures or screenings.
- AD&D rider (accidental death & dismemberment). Covered employees can receive a benefit of up to $50,000 for an accidental death or accidental dismemberment.
- Hospital confinement for sickness rider. Adding this rider provides an additional benefit payment for each day a covered employee is in the hospital due to sickness.
- Disability rider. This rider provides a benefit payment of up to $350 a week for up to 52 weeks if a covered employee or covered spouse becomes disabled and unable to work.
4. How it works is simple
Accident insurance helps the covered person focus on getting better without worrying about their finances. Payments go right to the covered employee – not to the doctors or the hospital. Payments are made regardless of other insurance and the money can be used any way the insured employee chooses – for out-of-pocket medical expenses, travel costs, child care, groceries, or any other expense.
Here’s an example of how simply Guardian’s Accident Insurance works
When a covered employee's daughter has a collision while playing centerfield for her little league team, she's taken to the hospital in an ambulance and given an MRI to check for injuries. The MRI confirms a concussion and she stays the night in the hospital for observation.
Here's the breakdown on what Guardian Accident Insurance may cover. And since the child was injured while playing organized sports, payments are increased by up to 25%1 under our child organized sport benefit. We also cover baseline concussion studies, which are required by many youth sports leagues.
In this example, Guardian pays a certain amount for each covered procedure.
ORGANIZED SPORT BENEFIT
|Emergency Room Visit||$100||$25|
(Over 20 hours)
|2 follow-up doctor visits||$50 X 2 = $100||$25|
This is a hypothetical example. A person’s eligibility for benefits is determined on a case-by case basis, taking into consideration the factual circumstances presented as well as the terms and conditions of his/her policy