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Gap HCI Plan
Individual - $110 per month
Individual + 1 - $170 per month
Family - $190 per month
Accident & Sickness Limited Benefit Cash Insurance helps with out-of-pocket costs due to accident or sickness by offering hospital admission indemnity, in-hospital indemnity, surgical indmenity, intensive care unit indemnity, physician office visit indemnity, & emergency room indemnity benefits. The Gap HCI Plan is a great fit for families, people that just want that extra layer of financial protection for some of their out-of-pocket costs due to an accident, for an emergency room visit or being admitted to the hospital. Gap HCI Plan is designed to supplement your comprehensive health insurance plan for help with out-of-pocket costs.
GROUP ACCIDENT & SICKNESS LIMITED BENEFIT CASH INSURANCE
VIEW GAP HCI PLAN EXCLUSIONS & LIMITATIONS HERE
Percentage of Benefit Amount Paid
Eligible Spouse of Covered Member*
Eligible Dependent Child(ren) of Covered Member*
*Spouse and Dependent Child(ren) are eligible if listed on the Membership Enrollment Application or later added, recorded, and acknowledged by the Association and meet the age requirements listed in the Policy Certificate.
HOSPITAL ADMISSION INDEMNITY BENEFIT
Group Accident & Sickness Limited Benefit Cash Insurance
|Benefit Amount per Hospital Admission||$750|
|Max # of Admissions per Sickness or Accident Per Plan Year||1|
We will pay a Hospital Admission Benefit if a Covered Person is admitted to a Hospital and Confined due to a Sickness or as the result of an Accident. The Covered Person must become confined within 6 months after the Covered Accident. We will not pay more than the maximum number of admissions as shown above.
No Hospital Admission benefits will be paid for: Emergency Room Treatment; Outpatient Treatment; or a Stay of Less than 20 Hours in an Observation Unit.
Reduction of Benefit Amounts for All Benefits Provided
If a Covered Person is age 65 years old or older on the date of loss covered under this Policy, the benefit otherwise payable will be reduced according to the schedule below.
Amount of Benefit Amount after Reduction
65 Years Old on Date of Loss is:
of the benefit amount
Amount of Benefit Amount after Reduction
70 Years Old on Date of Loss is:
of the benefit amount
Gap HCI Plan is available in the following States
AL, AZ, AR, DE, DC, FL, GA, IL, IN, IA, KY, MI, MS, NC, NE, ND, NM, OH, OK, PA, RI, SC, TN, TX, VA, WI & WY
CA and NV
The following monthly insurance rates apply to coverage underwritten by Federal Insurance Company. Your overall total association membership dues include these insurance rates:
Plan 1: Individual=$58.71; Ind+Spouse= $103.33; Family=$125.29
Plan 2: Individual=$62.48; Ind+Spouse=$109.97; Family=$133.34
HOW TO FILE AN ACCIDENT & SICKNESS
LIMITED BENEFIT CASH INSURANCE CLAIM
Coverage becomes effective on the date provided in your membership material following the receipt of the Application and the payment of the first month's dues by the United Business Association.
Federal Insurance Company, a member of the Chubb Group of Insurance Companies, is the underwriter of the Group Accident and Sickness Limited Benefit Cash Insurance. Federal Insurance Company and Chubb do not provide nor are affliated with the discount programs provided as part of membership in the United Business Association.
Benefit payment is subject to the terms, conditions, limitations, exclusions and other provisions within the Certificate. For more information and complete details of terms, conditions, limitations and exclusions of coverage, please refer to the Certificate. Coverage may vary and may not be available in all states. Written Claim Notice must be given to Us within twenty (20) days after the occurrence or commencement of any loss covered by this policy or as soon as reasonably possible. Notice must include enough information to identify the Covered Person and the Policyholder. Failure to give Claim Notice within twenty (20) days will not invalidate or reduce any otherwise valid claim if notice is given as soon as reasonably possible.
THIS IS A LIMITED FIXED INDEMINTY INSURANCE POLICY.
THIS IS NOT COMPREHENSIVE MAJOR MEDICAL INSURANCE.
THIS IS AN ACCIDENT & SICKNESS LIMITED BENEFIT CASH INSURANCE ONLY POLICY.
This information is a brief description of the important features of this insurance plan. It is not an insurance contract. Insurance benefits are underwritten by Federal Insurance Company. Coverage may not be available in all states or certain terms may be different where required by state law. Chubb NA is the U.S. - based operating division of the Chubb Group of Companies, headed by Chubb, Ltd. (NYSE:CB). Insurance products and services are provided by Chubb Insurance underwriting companies and not by the parent company itself. Federal Insurance Company and Chubb do not provide nor is affliated with the discount programs provided as part of membership in the United Business Association. This Policy provides limited benefits on a fixed indemnity basis. It does not constitute comprehensive health insurance coverage (often referred to as "major medical coverage") and does not satisfy a person's individual obligation to secure the requirement of minimum essential coverage under the Affordable Care Act (ACA). For more information about the ACA, please refer to http://www.healthcare.gov. Group Policy No: 9908-17-48 issued to the United Business Association. Coverage becomes effective on the dates provided in your membership material. Chubb Accident & Health, 202 Halls Mill Road, Whitehouse Station, NJ 08889. Click Here for the Chubb Privacy Notice.
United Business Association
The United Business Association (UBA) is a nationwide membership of small business owners and employees. UBA leverages our purchasing power to secure benefits and discounts not otherwise available on an individual basis. With group insurance programs, shared business knowledge, business and lifestyle benefits and services and opportunities to network, We are Better Together. Your membership in the United Business Association allows you to access and enroll in any additional Gap Plan that provides an insured benefit. Various insurance companies have issued group limited benefit insurance policies to the United Business Association as the group master policyholder. Product features, additional plans and availability may vary by state. View UBA's Refund / Cancellation Policy.
*Plan Costs listed at the top of the page do not include the separate $10 UBA Membership dues. You must be a member of the United Business Association to access and enroll in this Gap Plan.