Accident Protection

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Premium Rates

Monthly Premiums (12 month employee) 

Coverage Monthly Premium
Employee Only $9.15
Employee + Spouse $13.60
Employee + Child(ren) $12.36
Family $16.81
 
Monthly Premiums (9 month employee) 
 
Coverage Monthly Premium
Employee Only $12.20
Employee + Spouse $18.13
Employee + Child(ren) $16.48
Family $22.41
 

Plan Benefits

24 Hour Coverage/On and Off-the-Job Coverage 

Accidental Death & Dismemberment Initial Care Hospital Admission
Life
Both hands or feet or combination
One hand or foot
Two or more fingers or toes or combination
One finger or toe Child benefit – 50% of employee/spouse
$20,000
$20,000
$10,000
$4,000
$2,000
Ground Ambulance $200   $800
Air Ambulance $1,200 Hospital Inpatient Stay
(per day up to 365 days)
$160
Emergency Room Treatment $100 Hospital Intensive Care
Unit (ICU) Admission
$2,500
Accidental Death Common Carrier
(while on public transportation)
Child benefit – 50% of employee/spouse
$80,000 Physician Office Urgent Care (per visit)
$40
Hospital ICU Inpatient Stay
(per day up to 30 days)
$500
Waiver Premium Yes

Enhanced Benefits

Follow Up Care

Enhanced Benefit Coverage (sample of benefits included) Scheduled Benefit
Major Diagnostic Care
  • $160
Follow up Physician Visit
  • $40
Medical Appliances (equipment)
  • $140
Physical Therapy (per day up to six days)
  • $30

Prosthetic

  • One device
  • Two or more devices

 

  • $500
  • $1,000

Rehabilitation Unit (per day up to 30 days)

  • $80

 

Common Injuries

See Summary of Benefits for complete list.

Enhanced Benefit Coverage Scheduled Benefit

Abdominal/Thoracic (abdomen/chest) Surgery

  • Surgery to repair
  • Exploratory without repair

 

  • $1,000
  • $100
Blood/Plasma/Platelets
  • $280

Burns

  • 2nd Degree (at least 36% of body surface)
  • 3rd Degree (9-34 sq. inches)
  • 3rd Degree (35 or more sq. inches)

Skin Graft - 25% of burn benefit

 

  • $500
  • $1,000
  • $8,000

Coma

  • $10,000

Concussion (once per 12 month period)

  • $140

Dental Emergency

Broken teeth repaired with crown(s)
Broken teeth resulting in extractions

 

  • $200
  • $80

Eye Surgery

  • $200


Watch Now! Accident Protection Plan Brainshark
: A customized multimedia presentation designed to inform and educate eligible employees about their UnitedHealthcare benefits. 

ACCIDENT PROTECTION

UnitedHealthcare Customer Service: 1-888-299-2070

Policy #303972

Visit unitedhealthcare

 

Job Aids & RESOURCES

Change benefits

Manage (Add/Remove) Dependents

*Accident Protection Insurance and Dependents can only be changed during Annual Enrollment or due to a Qualifying Event.

List of Qualifying Events

Modify/Change Personal Information (Name/Address)

summary of benefits

BENEFICIARY FORM

how to file a claim

claim form

coverage policy