Accidental Death & Dismemberment (New York)
- Request for Quote
- Eligible Groups
- Eligible Persons
- When Are They Covered?
- Description of Benefits
- Optional Benefits
- Exclusions
- Plans
- Dependents Coverage
- Special Programs and Coverages
- Rates
- Administration
- General Remarks
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Eligible Groups
The ADD program is generally available in New York to the following organizations:
- Any corporation, partnership, individual employer, or any government corporation, agency or department with 20 or more employees. A minimum of ten employees must be covered.
- Professional Associations and Affinity groups are eligible but
have special requirements. In addition, the groups must meet the following
standards:
- Local and state wide organizations must have at least
5,000 eligible members.
- Nationwide organizations must have at least 15,000 eligible
members.
- Must be in existence for at least two years.
- Must have a constitution and bylaws.
- Must be formed for purposes other than obtaining insurance.
- Must have a central headquarters and staff willing and able to strongly back the program and willing to advise members.
- Local and state wide organizations must have at least
5,000 eligible members.
- Financial organizations covering customers are eligible.
Contact your reporting office for details concerning these groups.
Eligible Persons
Each employee or member, less than age 75, of the policyholder is eligible for insurance under the policy. If the plan includes dependent coverage, the insured's spouse and unmarried children who are less than age 19 (23 if a full-time student and primarily dependent upon the insured for support) will be eligible for insurance.
When Are They Covered?
Insureds (and if family coverage is purchased,
their eligible dependents) are covered 24 hours a day anywhere in the
world, whether at home or on the job or while traveling on business or
for pleasure.
Description of Benefits
Accidental Death and Dismemberment - This benefit must be included in the plan. It may be purchased alone, or in conjunction with other benefits.
This benefit provides the full Principal Sum in the event of accidental
loss of life, two limbs, the sight of both eyes, one limb and the sight
of one eye, or speech and hearing. One-half the Principal Sum is payable
for loss of one limb, sight of one eye, or speech or hearing. One-quarter
the Principal Sum is payable for loss of thumb and index finger of the
same hand.
Optional Benefits
The following are benefits that could be paid in addition to the Accidental Death and Dismemberment Benefit.
Accidental Hospital Indemnity Benefit - Provides a monthly benefit when injury due to an accident results in hospital confinement.
Adaptive Home and Vehicle Benefit - Provides a benefit if a covered loss, other than loss of life, occurs and expenses are incurred for alterations to the principal residence to make it accessible or to the private automobile to make it driveable or rideable.
Anti-inflation Benefit - Provides for the Principal Sum under the Accidental Death and Dismemberment Benefit to be automatically increased on an annual basis.
Common Carrier and Scheduled Aircraft - Provides passenger coverage while boarding or alighting from a Scheduled Aircraft or Common Carrier, including traveling directly to or from an airport immediately before departure or after arrival.
Common Disaster Benefit - This benefit increases the spouse's Principal Sum to equal the Insured's Principal Sum if both die in the same covered accident.
Conversion Privilege - Allows an insured to convert his or her coverage to an individual Accidental Death and Dismemberment Insurance policy.
Day Care Benefit - If the employee (or covered spouse, optional) loses his or her life in a covered accident, this benefit will provide an annual payment for up to 4 years for child day care expenses.
Dependent Child Dismemberment Benefit - The amount payable for a child's dismemberment will be doubled under this benefit.
Double Indemnity on a Common Carrier - This benefit doubles the Principal Sum payable under the Accidental Death and Dismemberment benefit if loss occurs while a passenger on a common carrier.
Education Benefit - If the employee (or covered Spouse, optional) loses his or her life in a covered accident, an annual payment for up to 4 years is payable if the covered dependent child is unmarried and a full-time student in an institution of learning. If no child qualifies for this benefit, a minimum amount will be paid.
Extended Dependents Benefit - If the employee dies in a covered accident, the premium for the Covered Dependents will be waived for up to 1 year.
Funeral Expense Benefit - Provides a benefit for funeral expenses when a covered loss of life occurs.
Paralysis- The full Principal Sum is payable for covered accidents resulting in quadriplegia; 75% of the Principal Sum for paraplegia; or 50% of the Principal Sum for hemiplegia. (Included as part of the Accidental Death and Dismemberment Schedule).
Permanent Total Disability - Provides a full Principal Sum, less any amount paid or payable under the Accidental Death and Dismemberment Benefit, if a covered accident results in total disability within 365 days of the accident. Payout can be lump sum, monthly or weekly. Available for employees or members and spouses.
Rehabilitation Benefit - Provides a benefit for a covered loss, other than loss of life, for training to prepare a person for work he/she would not otherwise have done.
Repatriation Benefit - Provides payment for preparation and transportation of the body for cremation or burial for covered loss of life occurring outside the state of residence.
Seat Belt Benefit - Provides a benefit if covered loss occurs while wearing a seat belt in an automobile.
Spouse Education - Provides a benefit for a covered spouse, upon the death of the employee, for occupational training to prepare a person for work not previously qualified for.
Survivor Benefit - Provides a monthly benefit for a surviving covered spouse upon the covered accidental death of the spouse.
Waiver of Premium - Premium is waived for any period of total
disability.
Exclusions
The policy does not cover any loss resulting from: intentionally self-inflicted injury, suicide or attempted suicide; war or act of war, whether declared or undeclared; injury sustained while full-time in the armed forces of any country or international authority; injury sustained while riding as a passenger on an aircraft owned, operated or leased by or on behalf of the policyholder or by an employer of the insured person; injury sustained while riding as a passenger in any military aircraft other than AMC*; injury sustained while operating or serving as a crew member of any aircraft; injury sustained while voluntarily taking drugs, including sedatives, narcotics, barbiturates, amphetamines, or hallucinogens, unless the drug is taken as prescribed for or administered by a licensed physician; sickness or disease except a pus forming infection which occurs through an accidental wound.
Note: For additional premium, aircraft and war risk exclusions can be removed.
*Air Mobility Command
Plans
The ADD program is available on a mandatory
or voluntary plan basis. When coverage is mandatory, all eligible employees
or members are covered and the Policyholder pays the premium. When coverage
is voluntary, only those eligible employees or members who enroll in the
program are covered. Most voluntary plans allow employees or members to
cover their spouse and children. The employee or member pays the premium
under a voluntary plan.
Dependents Coverage
Under a "standard" family plan, dependents are covered for a percentage of the employee's or member's principal sum. The most common plan is 50/40/10/15, which covers all eligible dependents based on the composition of the family at the time of loss. The employee or member is covered for 100% of the principal sum. The spouse is insured for 50% of the principal sum if there are no eligible dependent children. If there are eligible dependent children, the spouse is insured for 40% and each child for 10% of the principal sum. If there is no spouse, each child is covered for 15% of the principal sum.
The Hartford's program is flexible to offer other combinations of percentages. In addition, we can provide non-standard family plans or spouse only coverage, child only coverage, employee/spouse or employee/child combinations.
Special Programs and Coverages
The Hartford also offers the following:
Credit Card Program - Available on a mandatory basis to a bank's Mastercard or Visa cardholders and their spouses and dependent children. An insured is covered while riding as a passenger on a common carrier (commercial air, bus, ship, etc.) when such fare is charged to the card.
Occupational Only Coverage - Available on a mandatory basis to an employer to cover their employees for accidents resulting in death or dismemberment while working on the job, including while traveling on a business trip.
Carve out of ADD from the Group Life Insurance Program - Many times the ADD is written as part of the Group Life contract. We can write the ADD as a separate contract from the Group Life. Since we specialize in ADD business, most times the rates are lower and benefits broader than if the ADD stayed with the group life carrier.
Rates
The following rates apply to an employer group covering up to 100 full-time employees in non-hazardous occupations under a voluntary plan. This assumes the employer is the Plan Administrator and payroll deducts premium on a monthly basis. This is for the ADD benefit only and the dependents are covered for the 50/40/10/15 family plan.
| Employee only rate | $0.046/$1,000/month |
| Employee and Family rate | $0.064/$1,000/month |
These rates are provided for guideline purposes. Please contact your reporting office for a quote based on the specifics of the submission.
Administration
The Plan Administrator* or agent will assume the cost of and perform the following functions:
- All solicitations and sales activity;
- All mailings, including addressing and postage;
- Billing, collection and accounting for premiums;
- Issue certificates;
- Initial contact with insureds at time of claim;
- Verification of coverage to The Hartford's claim office.
The Hartford will:
- Prepare and print sales brochures;
- Print certificates;
- Pay claims.
*In most employer groups, the employer is the Plan Administrator and premium is payroll deducted. Other administrative arrangements may be made with a subsequent adjustment in commission.
These rates are provided for guideline purposes. Please contact your
reporting office for a quote based on the specifics of the submission.
General Remarks
Each employee or member enrolling in the plan will receive a Certificate of Insurance.
The policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department.
IMPORTANT NOTICE - THE POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS
Request for Quote
All quoting will be done by The Hartford. To obtain a quote, please contact your reporting office. The following information is required:
- Name/address of business.
- Nature of business.
- Number of eligible lives (salaried)/Number of eligible lives (hourly), including description of hourly occupations.
- Does the organization offer a plan now? If yes, with which company? If possible, please provide a) a copy of the current plan, and b) three years premium and claims information.
- Type of plan - Mandatory,Voluntary or both.
- Principal Sum/Limits desired.
- Optional Benefits desired.
- Are dependents to be covered?
- Will premium by payroll deducted on a monthly basis?