Group Accident Only Insurance

Group Accident Only insurance is issued on Policy form series MP-1300/MP-1400, Certificate form series GC-1300/GC-1400, and Rider form series GRG15CR/GRG15HAS by Guarantee Trust Life Insurance Company (GTL), Glenview, IL. The policy is issued to United Family Association (UFA) and has exclusions, limitations, and reductions of benefits. Subject to state availability and variability.

Cancellation/Termination of Benefits: Coverage terminates when the Association terminates the policy, your membership ceases, insurance ceases for your class, for non-payment of premium by the Association, or the date of fraud or misrepresentation of a material fact. The group policy terminates for non-payment of premium, if group participation requirements are not met or on any premium due date for any of the following reasons: fraud or misrepresentation of a material fact; failure of the Association to provide required information; or at GTL's discretion within 30 days. Notice of termination provided to the association is considered notice of termination to all members and will not be sent to you individually by GTL.

The following rates apply for coverage underwritten by Guarantee Trust Life Insurance Company as part of your membership in the United Family Association.

The rates for Executive Plus Membership are: $10,000 Group Accident Only: Individual = $24.67, Family = $59.16 per month.

The rates for Premium Plus Membership are: $10,000 Group Accident Only: Individual = $8.73, Family = $20.95 per month.

The Accident Medical Expense Benefit (AME) pays in excess of any other insurance coverage you may have for the expenses you are charged by a hospital, doctor, or certain other charges, up to a maximum of $10,000 if you are injured in a covered accident. Subject to a $100 deductible.

Not available in MD, MN, MT, NH, NM, NY, UT, WA

The Accidental Death & Dismemberment Benefit (AD&D) pays the beneficiary up to $10,000 for the member’s death or loss of certain body parts (e.g. limbs, speech, eyesight, or hearing) in a covered accident.

If, within 365 days from the date of an Accident which occurs while coverage is in force, Injury from such Accident results in a loss covered by this benefit, benefits will be provided in the amount set opposite such loss, as shown on the Schedule of Benefits. If more than one such loss is sustained as the result of one Accident, only one benefit amount will be paid, the largest to which the Covered Person is entitled.

Not available in MD, MN, MT, NH, NM, NY, UT, WA

Only available on the Premium Plus Association Membership

The Disability Income Benefit (DI) pays a weekly benefit of $150, not to exceed 26 weeks, if you become disabled from a covered accident and are unable to work in your usual job. This benefit has an elimination period of 30 days. For any part of a Disability that is less than a full week, 1/7 of the Disability Income Benefit will be paid for each day that You are disabled.

Not available in MD, MN, MT, NH, NM, NY, UT, WA

Only available on the Executive Plus Association Membership

The Cancer Lump Sum Benefit Rider and Limited Specified Disease Benefit Rider (Critical Illness) pays the insured up to $10,000 in the event they are diagnosed with a critical illness such as cancer, heart attack, or stroke. There is a waiting period of 60 days and a pre-existing period of 12 months for which the benefit eligibility for pre-existing conditions is 12 months after the rider effective date.

Not available in AK, CA, CO, CT, FL, ID, IN, KS, KY, ME, MD, MI, MN, MO, MT, NH, NJ, NM, NY, RI, SD, TN, UT, VT, WA

Cancer Definition: Cancer means a disease manifested by the presence of a malignancy characterized by the uncontrolled growth and abnormal spread of malignant cells and the invasion of body tissue by such malignant cells. Cancer includes Hodgkin’s disease and leukemia. This definition excludes such cancers as:

• 1. Pre-malignant tumors or polyps;
• 2. Skin Cancer, except malignant melanoma; and
• 3. Cancer In Situ.

Cancer will not be a covered condition when advice or treatment is received within the Waiting Period, if any, or prior to the Effective Date, and such advice or treatment leads to the Diagnosis of Cancer. If tissue is extracted during the Waiting Period, if any, or prior to the Effective Date, and results in a Diagnosis of Cancer, this will not be a covered condition. If Cancer is Diagnosed and/or treated within the Waiting Period, or if medical advice is given within the Waiting Period which leads to the subsequent Diagnosis of Cancer after the Waiting Period, the Covered Person has the option to cancel the Rider and receive a refund of all premiums paid on this Rider. For the purposes of this Rider, the date of Diagnosis will be considered to be the earlier of the date of clinical Diagnosis or the date the specimen used to diagnose Cancer is taken.

The Policy does not provide benefits for:

• Treatment, services or supplies which:
  • Are not Medically Necessary;
  • Are not prescribed by a Doctor as necessary to treat an injury;
  • Are determined to be Experimental/Investigational in nature;
  • Are received without charge or legal obligation to pay;
  • Are received from persons employed or retained by any Family Member, unless otherwise specified; or
  • Are not specifically listed as Covered Charges in the Policy.
• Injury by acts of war, whether declared or not.
• Injury received while traveling or flying by air, except as a fare-paying passenger and not as a pilot or crew member, on a regularly scheduled commercial airline.
• Injury covered by Worker’s Compensation, Employer Liability law or Occupational
Disease Act or Law.
• Dental treatment, except as specifically stated.
• Injury sustained while committing or attempting to commit a felony.
• Prescription Drugs except as specifically stated.
• Suicide or attempted suicide while sane or insane.
• Intentionally self-inflicted Injury.
• Loss resulting from being legally intoxicated or under the influence of alcohol as defined by the laws of the state or jurisdiction in which the Injury occurs.
• Loss resulting from being under the influence of any drugs or narcotics unless administered on the advice of a Doctor.
• Injury sustained while participating in or practicing for any professional, intercollegiate or sports activity, except as specifically provided.
• Injury which occurs while a Covered Person is on active duty service in any armed forces. Reserve or National Guard active duty for training is not excluded unless it extends beyond 31 days.
• Injury sustained flying in an ultra-light, hang gliding, parachuting or bungee-cord jumping, by flight in a space craft or any craft designed for navigation above or beyond the earth’s atmosphere.
• Injury sustained while driving or riding on vehicles for off-road use including but not limited to all-terrain vehicles (ATV’s).
• Injury sustained where a Covered Person is the operator and does not possess a current and valid motor vehicle operator’s license, except in a Driver’s Education Program.
• Treatment in any Veteran’s Administration or federal Hospital, except if there is a legal obligation to pay.
• Cosmetic surgery, except for reconstructive surgery on an injured part of the body.
• Covered Charges incurred outside of the United States or its possessions.
• Competing in motor sports races or competitions;
• Competing in water sports races or competitions;
• Testing cars/trucks on any racetrack or speedway;
• Handling, storing or transporting explosives;
• Scaling up cliffs or mountain walls;
• Spelunking (exploring caves);
• Handling or working with dangerous animals.
• Injury sustained while water skiing or surfboarding;
• Injury sustained while snow skiing or snowboarding;
• Injury sustained while roller blading or skateboarding;
• Injury sustained while participating in a rodeo.
• Reinjury or complications of an Injury caused or contributed to by a condition that existed before the Accident.
• Repetitive motion injuries, strains, hernia, tendonitis, bursitis and heat exhaustion not related to a specific injury.

A pre-existing condition is not eligible for benefits unless the Diagnosis occurs after this Rider Effective Date and the Waiting Period, if any, has expired. We will not pay benefits for a Pre-Existing Condition that is Diagnosed within the Pre-Existing Period stated in the Schedule of Benefits.

A Pre-Existing Condition is not covered unless the loss begins after the Benefit Eligibility Period for Pre-Existing Conditions has elapsed, as stated in the Schedule of Benefits. Cancer Benefit Rider and Specified Disease Benefit Rider Exclusions:

We will not pay benefits for:

• 1. A Positive Diagnosis of Cancer before the Effective Date of the Covered Person’s coverage under the Policy;
• 2. Any loss due to injury, disease or incapacity, unless related to or attributable to Cancer as defined;

Any Cancer when advice or treatment is received during the Waiting Period or prior to the Effective Date, and such advice or treatment results in a Positive Diagnosis of Cancer. If tissue is extracted during the Waiting Period or prior to the Effective Date, and results in a Positive Diagnosis of Cancer, this will not be a covered condition. For the purposes of this Rider, the date of a Positive Diagnosis of Cancer will be considered to be the earlier of the date of clinical diagnosis or the date the specimen used to diagnose Cancer is taken. If a Positive Diagnosis of Cancer is made and/or Cancer is treated within the Waiting Period, OR if medical advice is given within the Waiting Period which leads to the subsequent Positive Diagnosis of Cancer after the Waiting Period, the Insured has the option to cancel the Policy and receive a refund of all premiums paid on this Rider.

We will not pay benefits for claims resulting, whether directly or indirectly, from diseases that are related to, or are resulting from any of the following:

• 1. Any disease if the Covered Person was previously Diagnosed during the 12 months before the Rider Effective Date.
• 2. Any disease first Diagnosed within the Waiting Period, as shown in the Schedule, immediately following the Rider Effective Date.
• 3. Arrhythmia resulting in a Heart Attack that occurs in association with use of an illegal drug or controlled substance, except when administered in accordance with the advice of the Covered Person’s Doctor.
• 4. Any amount in excess of any Maximum Benefit for Covered Conditions.
• 5. Diseases or conditions that do not meet the definition of a Covered Condition in this Rider.
• 6. Suicide or attempted suicide.

A Pre-Existing Condition is a condition for which: (a) Medical advice or treatment was recommended by, or received from a Doctor, within the Pre- Existing Period shown above; or (b) symptoms existed which would cause an ordinarily prudent person to seek diagnosis, care or treatment within the Pre-Existing Period before the Effective Date of the Covered Person’s coverage. Treatment includes being prescribed or taking prescription drugs or medicines. A Pre-Existing Condition is not covered unless the loss begins after the Benefit Eligibility for Pre-Existing Conditions has elapsed.

Additional Disclosure

You have the option of downloading your certificate electronically. If you choose to do so, you are consenting to accept electronic delivery of your certificate. You also have the right at any time to receive a hard copy of your certificate.

The information contained herein is offered as insurance industry guidance and provided as an overview of current market risks and available coverages and is intended for discussion purposes only. This publication is not intended to offer legal advice or client-specific risk management advice. Any description of insurance coverages is not meant to interpret specific coverages that you may already have in place or that may be generally available. General insurance descriptions contained herein do not include complete insurance policy definitions, terms and/or conditions, and should not be relied on for coverage interpretation. Actual insurance certificates must always be consulted for full coverage details and analysis.

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