Midwest Coalition of Labor Trust, Bricklayers ADC of Eastern Missouri
Accident Insurance pays benefits for specific, covered accidents and injuries that happen on or after your coverage effective date. The benefit amount depends on the type of injury you have and the treatment you receive. Accident Insurance is a limited benefit policy. This is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. For a complete description of your available benefits, exclusions and limitations, see your certificate of insurance and any benefits.
Your Accident Insurance includes the following benefits:
If your accident happens while participating in an organized sporting activity mentioned in the certificate; the accident hospital care, accident care or common injuries benefit will be increased.
This is a yearly benefit you and everyone covered on your certificate can receive by completing an eligible health screening test.
Voya Cares® is not insurance coverage. It is a service offered through the Voya family of companies.
Group Name: Midwest Coalition of Labor Trust
Group Number: 706965
Certificates
Review this document for a complete overview of benefits
State Forms
Forms that provide additional information
What is Accident Insurance?
Accident Insurance pays you benefits for specific injuries and events resulting from a covered accident that occurs on or after your coverage effective date. The amounts paid depend on the type of injury and care received. Accident Insurance is a limited benefit policy. This is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.
How can Accident Insurance help?
You can use the benefit however you would like. Below are a few examples of how your Accident Insurance benefits could be used:
Can I purchase coverage for my spouse and child?
Coverage is available for your eligible spouse and your eligible children up to age 26* as defined in the certificate of insurance and riders, if employee coverage is elected.
*Standard ages may vary.
How much does it cost?
The cost of Accident Insurance varies. Please refer to your enrollment materials or contact your employer.
Do I need to provide health information?
No. Accident Insurance coverage is available on a guaranteed issue basis. Pre-existing condition limitation may apply.
This is a summary of benefits only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern. To keep coverage in force, premiums are payable up to the date of coverage termination. Accident Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Policy Form #RL-ACC2-POL-12; Certificate Form #RL-ACC2-CERT-12; and Rider Forms: Spouse Accident Rider Form #RL-ACC2-SPR-12, Children's Accident Rider Form #RL-ACC2-CHR-12, Wellness Benefit Rider Form #RL-ACC2-WELL-12, Accidental Death & Dismemberment (AD&D) Rider Form #RL-ACC2-ADR-12, Catastrophic Accident Rider Form #RL-ACC2-CAR-12, Off Job Accident Disability Income Rider form #RL-ACC2-DIR-12 and Sickness Hospital Confinement Rider Form #RL-ACC2-HCR-12. Form numbers, provisions and availability may vary by state.
John works full-time, while raising two energetic children and playing in a summer softball league. While sliding into home base, he broke his ankle and tore his ACL. Fortunately, this accident didn’t break John’s bank account and the benefits minimized the financial impact of his out-of-pocket expenses.
Example Out-of-Pocket Expenses
Emergency room copay | $100 | |
Deductible | $250 | |
Copay for surgery | $750 | |
Copay for 10 physical therapy visits | $150 | |
Total out-of-pocket expenses | $1,250 | |
Accident Insurance benefits paid1 | ||
Emergency room treatment | $300 | |
Initial doctor visit | $120 | |
Follow up doctor visit | $120 | |
Physical therapy ($75 per visit, up to 5) | $375 | |
Total benefits paid | $915 |
1 Example shows paid benefit amounts under level 3 coverage. Your employer may offer a different level of coverage with different covered benefits.
This is shown for illustrative purposes only. Actual results may vary. Average Accident Insurance claim paid from 1/1/2022 – 6/1/2022 was $1,111.91. For a complete description of your available benefits, exclusions and limitations, see your certificate of insurance and any riders.