Coverage
The Policy provides limited benefits for accidental death and dismemberment only. It does not provide basic hospital, basic medical, major medical or sickness coverage. It is not a Medicare Supplement policy.
The amount of benefits and premiums will depend upon the plan selected. If family coverage is selected, spousal coverage will be 75% of the primary insured’s amount and dependent coverage will be 10% of the primary insured’s amount. The benefit for the primary insured will be reduced to 65% at ages 70 – 74, 45% at ages 75 – 79 and 30% at ages 80 – 84. Coverage terminates at age 85.
The Policy does not cover loss caused or contributed by: sickness; intentionally self-inflicted injury, suicide or attempted suicide; war or while on active military duty; while on any aircraft as a pilot, crew member, student pilot, flight instructor, being used for tests, experimental purposes, stunt flying, racing or endurance testing or on any aircraft except a civil, public or military transport aircraft; while taking drugs unless prescribed or administered by a physician; while riding or driving in a scheduled race or testing
a motor vehicle on tracks, speedways or proving grounds; while committing or attempting to commit a felony; while intoxicated or driving while intoxicated.
The Policy is guaranteed renewable until the termination age. The terms of the policy cannot be changed except that, in the future, there may be a premium increase.
Premiums
Premiums are $6.30 per month for $100,000 of individual coverage, $11.10 per month for an individual and spouse, and $12.30 per month for a family. Monthly premiums for $250,000 of coverage are $15.75 for an individual, $27.75 for an individual and spouse, and $30.75 for a family.
For Policies issued in Colorado, South Dakota and Washington:
Premiums are $5.50 per month for $100,000 of individual coverage, $9.60 per month for an individual and spouse, and $10.70 per month for a family. Monthly premiums for $250,000 of coverage are $13.75 for an individual, $24.00 for an individual and spouse, and $26.75 for a family.
Important Notice
The Plan provides accident insurance only. It does not provide basic hospital, basic medical, major medical or sickness coverage. This is only a brief description of the coverage(s) available under policy form AH-45001 and its state variations. The policy will contain reductions, limitations, exclusions, and termination provisions. Full details of the coverage are contained in the policy. If there are any conflicts or discrepancies between this document and the policy or if any point is not covered in this document, the terms and conditions of the policy shall govern.
Premiums are based on the amount of benefit selected and the plan, individual or family, selected. Benefits will be reduced at age 70 and above and coverage will terminate at age 85.
The policy is administered by Starr Wright Insurance Agency, Inc., an insurance administrator licensed in the District of Columbia, license No. 3076489. Some coverage is underwritten by Starr Indemnity & Liability Company, an admitted insurer rated “A” (Excellent) by A.M. Best Company. Starr Indemnity & Liability Company, a Texas insurance company, has its principal place of business at 399 Park Avenue, New York, New York 10022. It is currently authorized to transact business in all states, the District of Columbia and Puerto Rico. NAIC No. 38318.