Powell Industries, Inc.
Powell Industries, Inc.
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:
Continuation allows you to maintain your current Accident Insurance coverage for yourself, your spouse and children during an employer-approved leave of absence.
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.
Certificates
Review this document for a complete overview of benefits
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:
Why should I enroll through my employer?
Premium amounts are deducted from your paycheck, so you don’t have to worry about paying another bill.
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. Fortunately, this accident didn’t break John’s bank account and the benefits minimized the financial impact of his out-of-pocket expenses.
Out-of-Pocket Expenses may include - Example Only
| Emergency room copay | $300 | ||
| Follow up doctor treatment copay ($60 per visit, 4 visits) | $240 | ||
| X-ray | $100 | ||
| Medical Equipment (crutches) | $150 | ||
| Copay for surgery for ankle fracture | $1,500 | ||
| Physical therapy copay ($50 per visit, up to 6) | $300 | ||
| Parking | $150 | ||
| Total out-of-pocket expenses | $2,740 | ||
| Accident Insurance benefits paid - Example Only1 | |||
| Emergency room treatment | $200 | ||
| Follow up doctor visit ($30 per visit, 4 visits) | $120 | ||
| X-ray | $40 | ||
| Medical Equipment (crutches) | $100 | ||
| Ankle fracture, open reduction | $1,500 | ||
| Physical therapy copay ($40 per visit, up to 6) | $240 | ||
| Sports Accident benefit (25% of total, up to $1,000) | $557 | ||
| Total benefits paid | $2,757 | ||
1 Example shows paid benefit amounts under level 3 coverage. Your employer may offer a different level of coverage with different covered benefits. Actual results may vary. Average Accident Insurance claim paid from 1/1/2023 – 9/15/2023 was $1,129.31. For a complete description of your available benefits, exclusions and limitations, see your certificate of insurance and any riders.
