Learn more about UBA's Most Popular
Optional Supplemental Insurance Category of Membership Products
issued to the United Business Association.
As a member of United Business Association, you have access to enhance your membership and add a plan that includes supplemental group insurance like accident, critical illness and more to your membership. UBA's most popular supplemental insurance category includes group and blanket group insurance from United States Fire Insurance Company, Sirius America Insurance Company, and Guaranteed Trust Life Insurance Company. Enhance your membership with United Business Association and add one of our Most Popular Membership Products to your membership. Most plans in this category also include the non-insurance Benefit Boost Subcription services. To view more about our optional Most Popular Plans: COMPLEMENT CARE underwritten by Sirius America Insurance Company, GAP AME 10K+ PLAN underwritten by Guarantee Trust Life Insurance Company, GAP 5000+ underwritten by Sirius America Insurance Company, GAP+ underwritten by United States Fire Insurance Company, GAP MAX+ underwritten by United States Fire Insurance Company, SUPER GAP+ underwritten by United States Fire Insurance Company, and GAP EDGE+ underwritten by Sirius America Insurance Company. (Select the name or scroll below.)
United Business Association (UBA) offers membership. This is a solicitation for UBA Memberships, NOT Insurance. Membership includes multiple benefits, including access to insurance products.
Complement your UBA Membership with the Complement Care Product underwritten by Sirius America Insurance Company, which offers valuable coverage for those that want that extra layer of protection for some out-of-pocket costs for physician office visits, urgent care center visits, or emergency room visits. Complement Care helps you get the care you need when you need it. Take care of yourself and complement your traditional health insurance. Complement Care is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership Product helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by Sirius America Insurance Company
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS, MT,
NC, ND, NE, NV, OH, OK, RI, SC, TN, TX, VA, WI, WV, & WY
$35 - Ind | $70 - Ind+1 | $120 - Family
*The membership product cost for the optional supplemental Complement Care Membership Product does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Physician Visit and Urgent Care Visit Benefit
$125 per visit up to 4 visits per Covered Person per Coverage Year.
A daily benefit will be paid for each visit made by a Covered Person to a Physician's Office or a licensed Urgent Care Facility to receive care or treatment of a Sickness, an Accident or an Injury.
Member and Dependent coverage ends when the Member is age 65.
Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company.
Emergency Room Visit Benefit
$500 per visit up to 2 visits per Covered Person per Coverage Year.
A daily benefit will be paid for a Physician's treatment of a Covered Person during an Emergency Room visit during which Emergency Care is provided for Sickness, Accident or Injury.
Member and Dependent coverage ends when the Member is age 65.
Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company.
Pre-existing Condition Limitation
The Policy will not cover any loss due to a Pre-existing Condition if the loss begins within 12 months after the Covered Person's effective date of insurance. However, the Policy may pay benefits for a loss due to a Pre-existing Condition of a Covered Person who was covered:
1. by a Replaced Policy; and
2. by the Policy, issued by Us to the Policyholder on the Policy Effective Date, and this Certificate.
The claim will be reviewed. If the Pre-Existing Condition Limitation in the Certificate does not apply, the benefits provided by the Policy and the Certificate will be paid.
If the Covered Person does not satisfy this Certificate's Pre-existing Condition Limitation, but can satisfy the Replaced Policy's pre-existing condition limitation giving credit for all time insured under both policies; then the benefit payable will be the lesser of:
1. the benefits provided by the Policy and the Certificate without applying the Pre-existing Condition Exclusion; or
2. the benefits provided by the Replaced Policy.
If the Covered Person does not satisfy the Certificate's Pre-existing Condition Limitation or that of the Replaced Policy, no Benefit will be paid.
Definition of Pre-existing Condition:
Pre-existing condition means a condition for which a Physician has treated or for which a Physician has advised treatment of the Covered Person within 12 months before the Covered person's effective date of insurance.
Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company.
Coverage Year:
Means a period beginning on the Primary Covered Person's Certificate Effective Date and ending 12 months after that date. Successive Coverage Years will begin after the first Coverage Year, each extending for 12-Month periods, provided that the Primary Covered Person does not terminate His coverage within the same Coverage Year. If the Primary Covered Person terminates His coverage during a Coverage Year and re-enrolls for coverage under a new certificate within the same Coverage Year, all benefits, benefit limits and benefit maximums will be those that applied to Him under the previously terminated certificate. In this case, a new Coverage Year will begin for the Primary Covered Person after He has been insured under the new certificate of a period of 12 months.
Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company.
ASSOCIATION BENEFITS
PROVIDED BY:
GROUP HOSPITAL INDEMNITY INSURANCE
UNDERWRITTEN BY:
Sirius America Insurance Company
BILLING*, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by Sirius America Insurance Company1. Your overall total association membership dues for the optional supplemental Complement Care Plan also include these monthly insurance rates:
1Group Hospital Indemnity Insurance:
$10.85 (Member), $23.44 (Member+1), $36.73 (Family)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Hospital Indemnity Insurance Policy is underwritten by Sirius America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Member and Dependent Coverage ends when the Member is age 65. We will provide coverage for the benefits and services shown in the Schedule of Benefits that are required for the Medically Necessary treatment of a Covered Person's Injury or Sickness while insurance under the Policy is in force, subject to all applicable terms, conditions, provisions and exclusions. Hospital Indemnity Benefits will be paid until any applicable Daily Benefit Amount or other benefit limit shown in the Schedule of Benefits has been reached; until the total of a Covered Benefit or Service equals any applicable Maximum Number of Daily Benefits, Lump Sum Benefit Amount, Maximum Number of Payments or Coverage Year Maximum shown in the Schedule of Benefits. Membership Product cost for the Complement Care Plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, Sirius America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
HASA-HI-1000
If you are looking for simple Accident Only Coverage with the added benefits of Benefit Boost, the Gap AME 10K+ Plan might be the right plan to add to your UBA Membership. The Gap AME 10K+ Plan offers valuable coverage for families, people who tend to be accident-prone or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident or injury along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap AME 10K+ Plan is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Plan helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by Guaranteed Trust Life Insurance Company (GTL)
AL, AZ, AR, CA, CT, DC, DE, FL, GA, IL, IN, IA, KS, KY, MI, MS, NC, ND, NE, NV, OH, OK, PA, RI, SC, TN, TX, VA, WV, WI & WY
$50 - Ind | $90 - Ind+1 | $120 - Family
*The plan cost for the optional supplemental Gap AME 10K+ Membership Product does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Group Accident Medical Expense Insurance
$10,000 Group Accident Medical Expense Benefit Maximum Benefit per injury.
$100 Deductible per injury.
Covered Services (as defined by policy) & Maximum Benefit:
Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company (GTL).
Group Accidental Death & Dismemberment Insurance
$1,000 Accidental Death & Dismemberment Benefit Principal Sum
Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company.
Along with the group insurance coverage provided in this Membership Product, the non-insurance UBA Membership Benefits provided by the United Business Association inlude 24-Hr Nurse Helpline, Lab Discounts, Discount Hearing Service, Safelite AutoGlass Discount, UBA Savings Perks Program and more. For full description of the UBA Membership non-insurance benefits and services, review the sample membership guide.
Guarantee trust Life Insurance does not offer and is not affiliated with the non-insurance services and discount programs offered in connection with membership in the United Business Association (UBA).
ASSOCIATION MEMBERSHIP BENEFITS
PROVIDED BY:
GROUP ACCIDENT INSURANCE ONLY INSURANCE
UNDERWRITTEN BY:
Guarantee Trust Life Insurance Company
BILLING*, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance.
Accident Medical Expense and Accidental Death & Dismemberment Benefits are offered under Group Accident Only insurnace issued on Policy form series MP-1300/MP-1400, Certificate form serices GC-1300/GC-1400, by Guarantee Trust Life insurance Company (GTL), Glenview, IL. The policy is issued to the United Business Association (UBA) and coverage is subject to all policy terms, definitions, conditions, exclusions, and limitations. Availability and terms under which coverage may be continued in force or discontinued, vary by state. For complete details of coverage, please contact us or see your certificate. you must be a UBA Member and elect to receive these benefits. Coverage is subject to termination in accordance with the Master Policy provisions. Notice of termination provided to the Association is considered notification to all Association Members and will not be sent to you individually by GTL. GTL provides the Group Accident Only insurance and does not provide nor is affiliated with the discount programs provided as part of membership in UBA.
The insurance described above provides limited benefits. Limited benefit policies are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. This insurance is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, this insurance is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act.
The following monthly insurance rates apply to coverage underwritten by Guarantee Trust Life Insurance Company. Your overall total association nmembership dues also include these insurance rates: Individual = $7.75; Family = $19.37.
As part of your overall Gap AME 10K+ Plan cost, the non-insurance Benefit Boost services retail at $25 (Individual), $40 (Ind+1), and $60 (Family). Guarantee Trust Life Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA). Plan Cost does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.
AAD101.15-19
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost Subscription Services which are:
All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap AME 10K+ Plan cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Guarantee Trust Life Insurance Company(GTL) does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealtyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The product provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsiblity for their own products.
Along with the long-established services available with your UBA Membership, the Gap 5000+ Plan, underwritten by Sirius America Insurance Company offers an extra layer of protection to offset some out-of-pocket medical costs due to an accident or being diagnosed with a covered critical illness for the first time (subject to policy & certificate of insurance terms, conditions, limitations & exclusions). This plan is perfect for those that are accident prone or who have a family history of heart attack, cancer or stroke. Gap 5000+ also includes the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap 5000+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership Product helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by Sirius America Insurance Company
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY
$30 - Ind | $50 - Ind+1 | $70 - Family
*The membership product cost for the Gap 5000+ Plan does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Blanket Group Accident Medical Expense Insurance
$5,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Blanket Group Accidental Death & Dismemberment Insurance
$2,500 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Blanket Group Accident Insurance is underwritten by Sirius America Insurance Company.
Critical Illness Insurance Benefit
$5,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $1000 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
Group Critical Illness Insurance is underwritten by Sirius America Insurance Company.
ASSOCIATION BENEFITS
PROVIDED BY:
BLANKET GROUP ACCIDENT INSURANCE
& GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
Sirius America Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by Sirius America Insurance Company1. Your overall total association membership dues for the optional supplemental Gap 5000+ Plan also include these monthly insurance rates:
1Blanket Group Accident Insurance:
$4.17 (Member), $8.37 (Member+1), $15.76 (Family)
1Group Critical Illness Insurance:
$3.26 (Member) & $6.51 (Member+Spouse)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Accident Insurance and Group Critical Illness Insurance are underwritten by Sirius America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Group Critical Illness Insurance Benefit Maximum is reduced if the first diagnosis occurs in the first year from the effective date. Membership Product cost for the Gap 5000+ Plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, Sirius America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
HASA-1000 | HASA-BAM-1000
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost Subscription Services which are:
All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap 5000+ Plan cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Sirius America Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealtyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The product provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsiblity for their own products.
Similar to Gap 5000+, the Gap+ Plan, underwritten by United States Fire Insurance Company, helps to bridge the gap for some unexpected out-of-pocket medical expenses due to an accident or being diagnosed with a covered critical illness for the first time (subject to policy & certificate of insurance terms, conditions, limitations & exclusions). But in addition to coverage for accidents or critical illness, Gap+ also includes a group hospital fixed indemnity insurance doctor visit benefit, laboratory testing benefit & x-ray/radiology benefit (coverage may vary or may not be available in all states). Built into the Gap+ Plan are the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership Product helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by United States Fire Insurance Company
AL, AR, AZ, DC, DE, FL, GA, IL, IN, IA, KY, LA, MI, MS, NE, NM, NC, ND, OH, OK, RI, SC, TN, TX, VA, WV, WI, & WY
$40 - Ind | $60 - Ind+1 | $80 - Family
*The membership product cost for the Gap+ Plan does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Group Accident Medical Expense Insurance
$5,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Group Accidental Death & Dismemberment Insurance
$2,500 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Group Accident Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Hospital Confinement Benefit
$500 Daily Hospital Confinement Benefit
Days 1-3 for hospital confinement in a policy period
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Physician Office Visit Benefit
$125 per day Daily Physician Office Visit Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.
Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Outpatient Diagnostic Radiology & X-Ray Benefit
$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.
Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Outpatient Diagnostic Laboratory Tests Benefit
$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.
Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Critical Illness Insurance Benefit
$5,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
Critical Illness Insurance Benefit is a rider to the Group Hospital Fixed Indemnity Insurance which is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
ASSOCIATION BENEFITS
PROVIDED BY:
GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
CRITICAL ILLNESS INSURANCE BENEFIT RIDER
UNDERWRITTEN BY:
United States Fire Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company1. Your overall total association membership dues for the optional supplemental Gap+ Plan also include these monthly insurance rates
1Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
1Group Hospital Fixed Indemnity Insurance:
$7.98 (Individual), $15.66 (Ind+1), $19.90 (Family)
1Critical Illness Insurance Benefit Rider:
$3.00 (Individual), $6.00 (Ind+1), $6.00 (Family)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance which also includes the Critical Illness Insurance Benefit Rider is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Membership Product cost for the Gap+ Plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, Crum & Forster, United States Fire Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
AH-4359
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost Subscription Services which are:
All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap+ Plan cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Crum & Forster and United States Fire Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealtyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The product provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsiblity for their own products.
Our most popular optional product, Gap Max+, underwritten by United States Fire Insurance Company, helps members become prepared for unexpected accident or first time critical illness events (subject to policy & certificate of insurance terms, conditions, limitations & exclusions). Gap Max+ also incudes group hospital fixed indemnity insurance emergency room visits and daily hospital confinement benefits (coverage may vary or may not be available for all states). Built into the Gap Max+ Plan are the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap Max+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership Product helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by United States Fire Insurance Company
AL, AR, AZ, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, RI, SC, TN, TX, VA, WI, WV & WY
$60 - Ind | $105 - Ind+1 | $130 - Family
*The membership product cost for the Gap Max+ Plan does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Group Accident Medical Expense Insurance
$10,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Group Accidental Death & Dismemberment Insurance
$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Group Accident Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Hospital Confinement Benefit
$500 Daily Hospital Confinement Benefit
Days 1-3 for hospital confinement in a policy period
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Emergency Room Visit Benefit
$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness
Max 10 days per policy period for Accident & Sickness
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Critical Illness Insurance Benefit
$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
Critical Illness Insurance Benefit is a rider to the Group Hospital Fixed Indemnity Insurance which is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
ASSOCIATION BENEFITS
PROVIDED BY:
GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
CRITICAL ILLNESS INSURANCE BENEFIT RIDER
UNDERWRITTEN BY:
United States Fire Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company1. Your overall total association membership dues for the optional supplemental Gap Max+ Plan also include these monthly insurance rates:
1Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
1Group Hospital Fixed Indemnity Insurance:
$9.04 (Individual), $18.07 (Ind+1), $31.63 (Family)
1Critical Illness Insurance Benefit Rider:
$7.86 (Individual), $15.73 (Ind+1), $15.73 (Family)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance which also includes the Critical Illness Insurance Benefit Rider is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Membership Product cost for the Gap Max+ Plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, Crum & Forster, United States Fire Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
AH-4359
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost Subscription Services which are:
All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall Gap MAX+ Plan cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Crum & Forster and United States Fire Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealtyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The product provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsiblity for their own products.
Super Gap+, underwritten by United States Fire Insurance Company, is similar to Gap Max+ offering valuable coverage to help with some out-of-pocket medical costs due to an accident or being diagnosed with a covered critical illness for the first time (subject to policy & certificate of insurance terms, conditions, limitions, & exclusions). In addition to the hospital fixed indemnity emergency room visit and daily hospital confinement benefit, Super Gap+ also includes a doctor visit benefit, laboratory test benefit, & x-rays/radiology benefit (coverage may vary or may not be available in all states). Built into Super Gap+ are the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Super Gap+ Plan is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership Product helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by United States Fire Insurance Company
AL, AR, AZ, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, RI, SC, TN, TX, VA, WI, WV & WY
$70 - Ind | $130 - Ind+1 | $150 - Family
*The membership product cost for the Super Gap+ Plan does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Group Accident Medical Expense Insurance
$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Group Accidental Death & Dismemberment Insurance
$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Group Accident Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Hospital Confinement Benefit
$500 Daily Hospital Confinement Benefit
Days 1-3 for hospital confinement in a policy period
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Emergency Room Visit Benefit
$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness
Max 10 days per policy period for Accident & Sickness
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Physician Office Visit Benefit
$125 per day Daily Physician Office Visit Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.
Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Outpatient Diagnostic Radiology & X-Ray Benefit
$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.
Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Daily Outpatient Diagnostic Laboratory Tests Benefit
$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit
2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.
In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.
Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.
Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
Critical Illness Insurance Benefit
$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
Critical Illness Insurance Benefit is a rider to the Group Hospital Fixed Indemnity Insurance which is underwritten by United States Fire Insurance Company.
Review the State Specific Certificate of Insurance to review coverage availability, terms, conditions, limitations and exclusions for your state. Coverage may vary or may not be available in all states.
ASSOCIATION BENEFITS
PROVIDED BY:
GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
CRITICAL ILLNESS INSURANCE BENEFIT RIDER
UNDERWRITTEN BY:
United States Fire Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company1. Your overall total association membership dues for the optional supplemental Super Gap+ Plan also include these monthly insurance rates:
1Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
1Group Hospital Fixed Indemnity Insurance:
$11.36 (Individual), $22.69 (Ind+1), $36.85 (Family)
1Critical Illness Insurance Benefit Rider:
$7.86 (Individual), $15.73 (Ind+1), $15.73 (Family)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance which also includes the Critical Illness Insurance Benefit Rider is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Membership Product cost for the Super Gap+ Plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, Crum & Forster, United States Fire Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
AH-4359
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost Subscription Services which are:
All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall SUPER GAP+ Plan cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Crum & Forster and United States Fire Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealtyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The product provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsiblity for their own products.
Along with the long-established services available with your UBA Membership, the Gap Edge+, underwritten by Sirius America Insurance Company offers an extra layer of protection to offset some out-of-pocket medical costs due to an accident or being diagnosed with a covered critical illness for the first time (subject to policy & certificate of insurance terms, conditions, limitations & exclusions) and coverage for doctor, urgent care & emergency room visits. This membership product combines the Gap 25000 and Complement Care Membership Products into one convenient package. Gap Edge+ also includes the highly regarded non-insurance benefit boost services like Virtual Urgent Care & Talk Therapy Visit telehealth services provided by Walmart Health Virtual Care, free vitamins and more. Gap Edge+ is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Membership Product helps to enhance and add more value to your membership in the United Business Association.
State Availability
Underwritten by Sirius America Insurance Company
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KY, LA, MI, MO, MS,
NC, ND, NE, NV, OH, OK, RI, TN, TX, VA, WI, WV, & WY
$65 - Ind | $125 - Ind+1 | $190 - Family
*The membership product cost for the Gap Edge+ Plan does not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance.
Blanket Group Accident Medical Expense Insurance
$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.
Blanket Group Accidental Death & Dismemberment Insurance
$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.
Blanket Group Accident Insurance Policy is underwritten by Sirius America Insurance Company.
Critical Illness Insurance Benefit
$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount
Maximum Lifetime Benefit Amount is $2500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.
Group Critical Illness Insurance Policy is underwritten by Sirius America Insurance Company.
Physician Visit and Urgent Care Visit Benefit
$125 per visit up to 4 visits per Covered Person per Coverage Year.
A daily benefit will be paid for each visit made by a Covered Person to a Physician's Office or a licensed Urgent Care Facility to receive care or treatment of a Sickness, an Accident or an Injury.
Member and Dependent coverage ends when the Member is age 65.
Emergency Room Visit Benefit
$500 per visit up to 2 visits per Covered Person per Coverage Year.
A daily benefit will be paid for a Physician's treatment of a Covered Person during an Emergency Room visit during which Emergency Care is provided for Sickness, Accident or Injury.
Member and Dependent coverage ends when the Member is age 65.
Pre-existing Condition Limitation
The Policy will not cover any loss due to a Pre-existing Condition if the loss begins within 12 months after the Covered Person's effective date of insurance. However, the Policy may pay benefits for a loss due to a Pre-existing Condition of a Covered Person who was covered:
1. by a Replaced Policy; and
2. by the Policy, issued by Us to the Policyholder on the Policy Effective Date, and the Certificate.
The claim will be reviewed. If the Pre-Existing Condition Limitation in the Certificate does not apply, the benefits provided by the Policy and the Certificate will be paid.
If the Covered Person does not satisfy the Certificate's Pre-existing Condition Limitation, but can satisfy the Replaced Policy's pre-existing condition limitation giving credit for all time insured under both policies; then the benefit payable will be the lesser of:
1. the benefits provided by the Policy and the Certificate without applying the Pre-existing Condition Exclusion; or
2. the benefits provided by the Replaced Policy.
If the Covered Person does not satisfy the Certificate's Pre-existing Condition Limitation or that of the Replaced Policy, no Benefit will be paid.
Definition of Pre-existing Condition:
Pre-existing condition means a condition for which a Physician has treated or for which a Physician has advised treatment of the Covered Person within 12 months before the Covered person's effective date of insurance.
Coverage Year:
Means a period beginning on the Primary Covered Person's Certificate Effective Date and ending 12 months after that date. Successive Coverage Years will begin after the first Coverage Year, each extending for 12-Month periods, provided that the Primary Covered Person does not terminate His coverage within the same Coverage Year. If the Primary Covered Person terminates His coverage during a Coverage Year and re-enrolls for coverage under a new certificate within the same Coverage Year, all benefits, benefit limits and benefit maximums will be those that applied to Him under the previously terminated certificate. In this case, a new Coverage Year will begin for the Primary Covered Person after He has been insured under the new certificate of a period of 12 months.
Group Hospital Indemnity Insurance Policy is underwritten by Sirius America Insurance Company.
ASSOCIATION BENEFITS
PROVIDED BY:
BLANKET GROUP ACCIDENT INSURANCE
& GROUP CRITICAL ILLNESS INSURANCE
& GROUP HOSPITAL INDEMNITY INSURANCE
POLICIES UNDERWRITTEN BY:
Sirius America Insurance Company
BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:
*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).
The following monthly insurance rates apply to coverage underwritten by Sirius America Insurance Company1. Your overall total association membership dues for the optional supplemental Gap Edge+ Plan also include these monthly insurance rates:
1Blanket Group Accident Insurance:
$8.54 (Member), $17.07 (Member+1), $32.18 (Family)
1Group Critical Illness Insurance:
$15.45 (Member) & $30.90 (Member+Spouse)
1Group Hospital Indemnity Insurance:
$10.85 (Member), $23.44 (Member+1), $36.73 (Family)
Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance membership products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Group Accident Insurance, Group Critical Illness Insurance, and Group Hospital Indemnity Insurance Policies are underwritten by Sirius America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Group Critical Illness Insurance Benefit Maximum is reduced if the first diagnosis occurs in the first year from the effective date. Membership Product cost for the Gap Edge+ Plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.
United Business Association, Sirius America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
HASA-1000 | HASA-BAM-1000 | HASA-HI-1000
Non-Insurance Services included in this plan.
This plan includes the highly-regarded Benefit Boost Subscription Services which are:
All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.
Dental Discounts powered by Aetna Dental Discount network are not available in AK, CT, IA, MA, RI, UT, VT, WA and this benefit is not available for the residents of Vermont.
As part of your overall GAP EDGE+ Plan cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).
If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the Walmart Health Virtual Care Visits telehealth services will be based on the Virtual PCP Solution Subscription telehealth services provided by Walmart Health Virtual Care.
Sirius America Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).
The $0 cost Virtual Urgent Care & Virtual Talk Therapy Visits - visits are paid by HealtyAmerica and not the member.
Read the guide carefully. This is a brief description of a virtual urgent care and talk therapy telehealth service provided by Walmart Health Virtual Care; dental discount program powered by the Aetna Dental Access® Network; a prescription discount program through Paramount RX®; free multi-vitamin service; and an identity theft discount program through LifeLock®; and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The product provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.
Walmart Health Virtual Care, Aetna Dental Access®, Paramount RX®, LifeLock®, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsiblity for their own products.
United Business Association, Crum & Forster, United States Fire Insurance Company, Sirius America Insurance Company, Guarantee Trust Life Insurance Company, MeMD®, Walmart Health®, Paramount RX®, Aetna Dental Access®, LifeLock®, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.
AH-4359 | AAD101-15.19
United Business Association (UBA) offers membership. This is a solicitation for UBA Memberships, NOT Insurance. Membership includes multiple benefits, including access to insurance products.