Accident Insurance

Accident Insurance  

Overview

An unexpected injury-related accident could mean a trip to the emergency room. And unanticipated, uncovered, after-treatment ER bills can add up quick. Your major medical insurance will help with many of your expenses, but wouldn't you feel better knowing you'll have extra help paying some of your bill?


Accident Insurance, underwritten by Transamerica Life Insurance Company, pays you a benefit to help cover your out-of-pocket expenses so you can focus more on getting well and less on the extra expenses an accident can bring. Benefits include:

  • Pays benefits for multiple numerous types of injuries related to accidents.
  • Employee group rates: You pay just $11.60/per paycheck.
  • Eligible spouse/domestic partner and children can be insured too.
  • Guaranteed acceptance with no medical exam if you enroll during the Enrollment Period.

 

Thanks to your employer’s group rates, you’ll pay less for this insurance than you would for individual insurance you’d find on your own.

Enroll online

Add Accident Insurance to help offset costs that may not be covered under your employer's existing medical plan.

Once you enroll, coverage will automatically renew unless you cancel during a subsequent Annual Enrollment period or experience a qualified status change that would allow such a change.

Click to learn more about Accident Insurance

AccidentAdvance_Waive/Enroll Ending from Transamerica Employee Benefits on Vimeo.

Contact Us

 Address
Mercer Voluntary Benefits
12421 Meredith Drive
Urbandale, IA 50398
 Phone
1-800-626-9011
 Hours
 M-F 8a-5p CT
 Email
employerbenefitsinquiries.service@mercer.com
EBD BJIRWEB 0618
  • Who is the provider?

    This is a summary of AccidentAdvance®, Accident Insurance underwritten by Transamerica Life Insurance Company, Cedar Rapids, Iowa Policy form series CPACC100 and CCACC100. Forms and form numbers may vary. This insurance may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details.

  • How can this help me?

    Most families don’t budget for the costs associated with accidents. When an accident does occur, the last thing on your mind is the charges accumulating while at the emergency room:

    • Ambulance ride
    • Casts
    • Use of the emergency room
    • Surgery and Anesthesia
    • Stitches
    • Bandages


    These costs can add up fast. Most families have medical insurance that will cover a majority of the expenses. But, what about the out-of-pocket medical expenses, such as lost wages an employee or spouse/domestic partner loses when out of work or staying home to care for an injured family member? You hope that an accident never happens, but at some point you very well may take a trip to your local emergency room. If that time comes, wouldn’t it be nice to have an insurance policy that pays you a benefit regardless of any other insurance you have? 

  • Who is eligible?

    You and your eligible family members just need to enroll during your enrollment period and be actively at work for your insurance to be effective. Some states require the insured to have medical coverage.

  • When can I enroll?

    As a new hire, you can enroll during your new hire enrollment period. Outside of your new hire enrollment period, enrollment is limited to the company’s annual enrollment period.

  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your insurance without interruption through the portability provision, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available if you retire or leave your company, you can opt for other payment methods such as monthly payment through Automated Clearing House or quarterly, semi-annual or annual direct bill. Higher rates may apply.

  • Will my rates increase as I get older or if I file a claim?

    No, your rates will not increase due to age, health or individual claims.
  • Will I have to take a medical exam to get this insurance?

    No! For the initial Open Enrollment period and for new hires added throughout the year, this insurance is guaranteed-issue (which means you may qualify for insurance without having to submit to a medical exam or answer health questions).
  • What types of accidents and injuries are covered?

    Once you’re enrolled in this insurance, you’ll collect benefits for various covered events, including:

     

    • Fractures
    • Dislocations

     

    You’ll also receive a lump-sum payment when you have these covered medical services/treatments:

     

    • Ambulance
    • Emergency care
    • Inpatient surgery
    • Outpatient surgery
    • Medical Testing Benefits including:
      • X-rays
      • MRIs
      • CT scans
    • Physician follow-up visits
    • Therapy services including:
      • Physical  therapy

     

Limitations and Exclusions

We will not pay benefits for losses caused by or as a result of a covered person:

  • Driving any taxi for wage, compensation or profit;
  • Mountaineering, parachuting or hang gliding;
  • Voluntarily taking, administering, absorbing or inhaling poison, gas or fumes;
  • Alcoholism or drug addiction;
  • Participating in any sport or sporting activity for wage, compensation, profit, or racing any type of vehicle in an organized event;
  • Traveling in or descending from any vehicle or device for aerial navigation, except as a fare paying passenger in an aircraft operated by a commercial airline (other than a charter airline) on a regularly scheduled passenger trip;
  • War, or any act of war, whether declared or undeclared;
  • Participating in any activity or event, including the operation of a vehicle, while intoxicated or under the influence according to the laws of the jurisdiction in which the accident occurred;
  • Participating in a riot, civil commotion, civil disobedience or unlawful assembly;
  • Committing, attempting to commit, or taking part in a felony or assault or engaging in an illegal occupation;
  • Intentionally self-inflicting bodily injury or attempting suicide while sane or insane;
  • Any loss incurred while on active duty status in the armed forces. If you notify us of such active duty, we will refund any premiums paid for any period for which no coverage is provided as a result of this exception.

 

All Disability Income Riders
Benefits are not payable for a disability that is caused by or occurs as the result of one of:

  • Disability that is being treated outside the territorial limits of the United States or, if outside of the United States, the territorial limits of the place where this rider was issued.
  • Any disability which begins after termination of coverage. This will not be considered a continuation of a previous disability and will not be covered under the contract.

Total disability exists when under the regular care and attendance of a physician for necessary treatment of a covered accident or sickness and not actually engaged in any substantially gainful occupation.

 

Total disability must begin while rider is in force and ends when released by a physician to return to work.
Total disability is the inability to:

  • Employed Full-Time: engage in or perform all of the material and substantial occupational duties.
  • Not Employed Full-Time: perform two or more ADLs (bathing, continence, dressing, eating, toileting and
  • transferring) without direct personal assistance, as certified by a physician, each time the activity is performed.

 

If more than one disability benefit is in force with us, rider benefits are reduced so that the total benefit from all disability coverage does not exceed 80% of a person's monthly compensation. Premium paid for disability benefits in excess of 80% will be refunded.

 

Sickness-Only Disability Income Rider
Benefits are not payable for a disability that is caused by, or occurs as the result of, childbirth or charges related to normal pregnancy within 10 months of the rider's effective date. Pregnancy complications are covered to the same extent as any other sickness.

 

No benefits are provided during the first 12 months for any sickness that has been diagnosed, treated, or for which the Insured has incurred expense or has taken medication within 12 months prior to this rider's effective date.

 

Termination of Coverage
Subject to the Portability Option, insurance coverage on the employee will end on the earliest of:

  • the date of his or her death;
  • the date he or she ceases to be eligible for coverage;
  • the last date for which premium payment has been made to us, subject to the grace period;
  • the date he or she terminates employment;
  • the date the group master policy terminates;
  • the date he or she sends us a written notice to cancel coverage.

 

The insurance coverage on a dependent will cease on the earliest of:

  • the date of the employee's death;
  • the date the employee's coverage terminates;
  • the last date for which premium payment has been made to us, subject to the grace period;
  • the date the dependent no longer meets the definition of dependent;
  • the date the certificate is modified so as to exclude dependent coverage;
  • the date the employee sends us a written notice to cancel coverage on a dependent.

 

Extension of Benefits
Whenever termination of coverage under this section occurs due to termination of employment, such termination will be without prejudice to:

  • any hospital confinement which began while coverage was in force; or
  • any covered treatment or service for which benefits would be provided and which began while coverage was in force; provided, however that the covered person is and continues to be hospital confined or receiving treatment.

Such Extension of Benefits will continue for up to the earlier of:

  • 30 days; or
  • the date on which the covered person is no longer hospitalized or receiving treatment.

 

Portability Option
If an employee loses eligibility for this insurance for any reason other than nonpayment of premiums, coverage can be continued by paying the premiums directly to us within 31 days after termination. We will bill the employee directly once we receive notification to continue coverage.

 

Termination of the Group Master Policy
The policyholder may end the policy on any premium due date by submitting a 60-day advance written notice. A group will not be continued if it drops below the minimum required participation. The group master policy will be terminated and coverage of all remaining insureds will end, subject to the Portability Option.

 

Other Insurance with Us
An individual can only have one accident policy or certificate with us. An individual can only have one disability income policy, certificate, or rider with us. If a person already has accident insurance with us, such person is not eligible to apply for this coverage. If a person already has disability income insurance with us, such person is not eligible to apply for the disability income riders.

 

122480R1 11/20

Mercer's Role & Compensation

Details of Mercer disclosure of the compensation.