Motor vehicle and other unexpected accidents cause 29 million trips to the emergency room each year.* Unanticipated—and uncovered—after-treatment ER bills average over $600.** Your major medical insurance will help with many of your expenses, but wouldn’t you feel better knowing you’ll have extra help paying some of your bill?
Accident Insurance pays you a lump sum cash benefit to help cover your out-of-pocket expenses so you can focus more on getting well and less on the extra expenses an accident can bring. Benefits include:
* National Safety Council, Injury Facts®, 2017 Edition
** CNBC, "Many get hit with surprise 'out-of-network' bill after emergency rooms: Study," viewed 6-15-17 at http://www.cnbc.com/2016/11/16/many-get-hit-with-surprise-out-of-network-bill-after-emergency-rooms-study.html
Answers about the plan, including eligibility, options, enrollment, customer service and more.
Who is the provider?
With over 145 years of experience, MetLife is a recognized leader in protection planning and retirement & savings solutions.
How can this help me?
Most families don’t budget for the costs associated with accidents. When an accident does occur, the last thing that should be on your mind is the charges accumulating while at the emergency room:
These costs can add up fast. Most families have medical insurance that will cover a majority of the expenses. But, what about the out-of-pocket medical expenses, such as required copay, or the lost wages an employee or spouse/domestic partner loses when out of work or staying home to care for an injured family member? You hope that an accident never happens, but at some point you very well may take a trip to your local emergency room. If that time comes, wouldn’t it be nice to have an insurance plan that pays you a benefit regardless of any other insurance you have? Group Accident insurance does just that, providing a cash benefit to cover the costs associated with unexpected trips to the emergency room.
Who is eligible?
You and your eligible family members just need to enroll during your enrollment period and be actively at work for your coverage to be effective. Dependents to be enrolled may not be subject to a medical restriction as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage.1
When can I enroll?
As a new hire, you can enroll during your new hire enrollment period. Outside of your new hire enrollment period, enrollment is limited to the company’s annual enrollment period.
What if my employment status changes?
When you leave or retire from your current employer, you can continue your coverage without interruption, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available if you retire or leave your company, you can opt for other payment methods such as direct checking or bank account deduction, or home billing.
Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier.2
Will my rates increase as I get older or if I file a claim?
No, your rates will not increase due to age, health or individual claims.
What types of accidents and injuries am I covered for?
Once you’re enrolled in this coverage, you’ll collect benefits for more than 150 different covered events3, including:
You’ll also receive a lump-sum payment when you have these covered medical services/treatments3:
Will I have to take a medical exam to get this coverage?
No! Your Accident insurance is guaranteed issue, which means your acceptance is guaranteed, provided you enroll during the Enrollment Period, are actively at work and dependents to be covered are not under a medical restriction as set forth in the Certificate. There are no medical exams to take and no health questions to answer. Some states require the insured to have medical coverage.1
1 Coverage is guaranteed provided (1) the employee is actively at work and (2) dependents to be covered are not subject to medical restrictions as set forth on the enrollment form and in the Certificate. Some states require the insured to have medical coverage. Additional restrictions apply to dependents serving in the armed forces or living overseas.
2 Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative.
3 Covered services/treatments must be the result of a covered accident as defined in the group policy/certificate. See the Disclosure Statement or Outline of Coverage/ Disclosure Document for more details.
4 Chip fractures are paid at 25% of Fracture Benefit and partial dislocations are paid at 25% of Dislocation Benefit.
METLIFE'S ACCIDENT INSURANCE IS A LIMITED BENEFIT GROUP INSURANCE POLICY. The policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage. The policy or its provisions may vary or be unavailable in some states. There is a preexisting condition exclusion for hospital sickness benefits, if applicable. MetLife’s Accident Insurance may be subject to benefit reductions that begin at age 65. And, like most group accident and health insurance policies, policies offered by MetLife may contain certain exclusions, limitations and terms for keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12-AX or contact MetLife. Benefits are underwritten by Metropolitan Life Insurance Company, New York, New York.