HEALTH/MEDICAL INSURANCE
 

The MIADA has engaged in a special relationship with Fallon Community Health Plan. The health plan includes HMO and PPO networks at competitive prices. Premium rates are determined by business classification, location and demographics of the participating employee group. In addition to the wide range of health insurance options provided through the Fallon network, participating employees receive, free of charge, the following ancillary benefits:

 

v$10,000 Life and Accidental Death and Dismemberment (AD&D) coverage issued by Anthem Life Insurance Company

vEmployee Assistance Program provided by KGA

 

 

For more information contact the advisors of Equity Services, Inc:

 

Michael R. Panico, CFP® x214

Joshua J. Paradis, CFP® x212

2 Newton Executive Park, Suite 200

Newton, MA 02462

Main: (617) 240-1697

 

HEALTH INSURANCE ANCILLARY BENEFITS SUMMARY

 

This is only a summary intended to be a brief outline of benefits available to eligible employees. It does not include all the terms of coverage under the group policy. The governing contractual provisions of coverage are contained in the group policy issued by Anthem Life Insurance Company to the New England Automobile Dealers Insurance Trust.

 

Group Term Life Insurance

Pays a death benefit of $10,000 to the eligible employee’s beneficiary in the event of the eligible employee’s death from any cause. Coverage ends at retirement.

 

Accidental Death & Dismemberment (AD&D) Insurance

Pays a benefit if the eligible employee loses his/her life or suffers a covered physical loss as a result of an accident. The death or loss must occur due to an accident, within 180 days after the accident. The accidental death benefit, payable to the eligible employee’s beneficiary, is $10,000. An additional $1,000 is paid if the eligible employee’s death is caused by an automobile accident while he/she is wearing a seat belt.

 

A benefit of $5,000 is paid to the eligible employee for loss of sigh in one eye, or loss of a hand or foot due to an accident. A $10,000 benefit is paid for multiple losses from the same accident. AD&D coverage ends at retirement.

 

No AD&D benefits are payable for a death or physical loss caused by or connected with suicide or self-inflicted injury committed or inflicted while sane or insane (in Missouri while sane); disease, physical or mental impairment, medical or surgical treatment, diagnostic or preventative care (unless such treatment or care is provided in connection with accidental injury) or infection (except infection of an accidentally caused wound); taking any drug or chemical unless taken as prescribed by a physician or as directed by the pharmaceutical manufacturer; auto-erotic asphyxiation; taking part in, committing, or attempting to commit an assault or felony; duty as a member of any military, naval or air organization; taking part in a riot or in any declared or undeclared war, flying in any aircraft as a pilot or crew member; experimental flying or flying for the purpose of training; riding, driving, or testing a vehicle used in a race or speed contest; taking part in the sports of parachute jumping, sky diving, or hang gliding; or operating a motor vehicle while under the influence of alcohol or drugs, as defined by state law.

 

Employee Eligibility

Eligible employees must be actively at work and insured for medical benefits under a group policy administered by the NEAD. 

 

DENTAL INSURANCE

  

Rates guaranteed with the MetLife National PPO through April 1, 2011:

Monthly rates:

 

 

Benefit Summary

 

*PDP Fee refers to the fees tha participating PDP dentists have agreed to accept as payment in full, subject to any co-payments, deductibles, cost sharing and benefit maximums.

**R&C Fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist’s actual charge, (2) the dentist’s usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife

 

 
 

GROUP LIFE / AD&D INSURANCE 
 

Underwritten by Anthem Life Insurance Company:

 

Employee Only Benefit:

 

Rates:

 

 

 

 

 

GROUP SHORT TERM DISABILITY

 

Underwritten by Anthem Life Insurance Company. This plan provides income for employees who become totally disabled from non-occupational accident or illness:

Employee Only Benefit:

 

 

v No benefits will be paid which exceed 70% of normal weekly salary.

 

v The benefit payable for each day of any period of total disability which is less than full week will be one-seventh of the weekly benefit described above.

 

v Benefits begin on the 1^st day of a disability resulting from an accident, on the 1^st day of hospitalization or the 8^th day of a disability as a result of sickness.

 

v Benefits are payable for a maximum of 26 weeks.

 

Rates:

 

 

VOLUNTARY LIFE / DISABILITY

  

When your business cannot afford to purchase any additional benefits but you want to get your employees access to voluntary benefits that they can pay for themselves, direct them to MIADA’s voluntary lines of coverage:

 

Voluntary Life:

 

Underwritten with Anthem Life Insurance Company.

Issue amounts of $25,000 - $100,000 based on simplified underwriting.

Policies issued on terms of 10, 20 or 30 years.

 

Voluntary Disability:

 

Did you know?

·        Last year 48% of all mortgage foreclosures resulted from loss of income?

·        3 out of 10 working individuals between ages 25 and 65 will become disabled for 90 or more at some point in their career?

 

Underwritten by American Fidelity Assurance Company.

Benefit pays for loss of income as a result of non-occupational accident, sickness or pregnancy.

Up to $3,000 of monthly benefit is offered guaranteed without underwriting.

Total benefit amounts available up to $6,000.

Benefit payable to age 65 for accidents, 5 ½ years for sickness.

Benefit begins after 1^st day after accident or 8^th day after sickness.

 

Rates: Dependent on age and amount of coverage selected.