High-Limit Accident Insurance Plan
The SPE High-Limit Accident Insurance Plan is designed to cushion that impact and protect you and your family from the financial effects of an accident with an affordable, high benefit safety net. It's an easy, inexpensive way to give your family extra protection - providing up to $500,000 in coverage - benefits your family can use if you are seriously injured or you die from a covered accident.
Eligibility Requirements
The SPE High-Limit Accident Insurance Plan is available to members under age 70, their spouses (under age 70) and each unmarried dependent child under age 25 (in Utah 26.)
Note: Eligible children include legally adopted children in all states.
This coverage may not be available in all states. Please call the administrator at 800-337-3140 to find out if it is available in your state.
This Plan Provides Benefits in Two Ways
1. Payment in lump sum...
if loss is directly and independently caused by an accident that occurs while coverage is in force, and such accident results in any of the losses* shown below within 365 days of the accident, the Insurance company will pay the benefit sum shown below. Only one of the sums, the largest available, will be paid for all injuries to any one limb resulting from a single accident. The total benefits payable for all losses due to a single accident will not be more than the principal sum. You will receive:
- 100% of Principal Sum for loss of life.
- 100% of Principal Sum for loss of two limbs, or movement of both upper and lower limbs (quadriplegia), or total loss of sight of both eyes, or both speech and hearing, or one limb and total loss of sight of one eye.
- 75% of Principal Sum for loss of movement of both lower limbs (paraplegia).
- 50% of Principal Sum for loss of one limb, or movement of both upper and lower limbs of one side of the body (hemiplegia) or total loss of sight of one eye, or speech, or hearing.
- 25% of Principal Sum for loss of thumb and index finger of either hand. Loss of thumb and index finger must be on the same hand.
2. Monthly Payments for Disability...
if a member is totally disabled because of an accident.
Each monthly payment is 1% of the Principal Sum you select up to $300,000. You can receive monthly payments for up to 100 months (i.e., until the total of your monthly payments equals your Principal Sum up to $300,000).
The disability must begin within 365 days of the accident, be sustained before you reach age 70, be the direct result of an injury, and continue without interruption for at least 12 consecutive months. The term "total disability" means:
- as the result of an injury, the inability of the covered person to perform the material and substantial duties of any occupation for which he is reasonably fitted by education, training, or experience; or
- if the covered person is not gainfully employed, the inability of the covered person to perform all normal daily activities of a person of like age and sex.
Special Benefits Prior to Age 70
Common Carrier Benefit
If a covered loss occurs as a result of an accident while a passenger on a common carrier, an additional $25,000 will be paid along with the Principal Sum Payable.
New Special Training Benefit
If your insured spouse is enrolled in a professional, trade training or educational degree program on the date of, or within 12 months following the accident causing your death, the Plan will pay up to an additional 4% of your benefit amount towards tuition in the program. The benefit will be paid in one lump sum upon proof of enrollment and payment of tuition or any appropriate fees and will not exceed the cost of your spouse's enrollment in the program.
Repatriation Benefit
If a covered accidental death occurs at least 100 miles from your permanent residence, an additional benefit of up to $5,000 of the actual expenses incurred will be paid for preparation and transportation of the body to the city of residence.
Continuous Coverage
Insurance for a member (and for insured dependents, as long as they remain eligible) remains in force unless you cease to be a member, or fail to pay premiums when due, or the group policy is terminated. A member's surviving spouse and children may continue coverage if it was in force at the time of the member's death.
Semiannual Premiums
You may select a Principal Sum of $50,000 to $500,000 for yourself and $50,000 to $250,000 for your spouse, as long as your spouse's coverage does not exceed your coverage. For those covering children, one premium covers all eligible children, regardless of how many, for $10,000 each. The premium for your spouse and children is based on your age and increases when you reach age 70.
To calculate the total semiannual premium, add the member premium, plus the spouse premium, plus the children's premium. Premium may also be paid annually. Just multiply the semiannual premium by two.
Note: A $2.00 administrative fee is added for billing modes other than annual.
Reductions and Exclusions
On the premium due date on or after the member's 70th birthday, member and spouse coverage reduces to a maximum $100,000 Principal Sum. At the same time, the premiums change as shown in the rate table.
The Plan will not pay a benefit for a loss which results from, is contributed to or caused by:
- suicide, attempted suicide or intentionally self-inflicted injury, while sane or insane (in Missouri while sane);
- declared or undeclared war or any act of war;
- full-time military service;
- participating in a riot; committing an assault (except CA and MN) or felony (exclusion not applicable in CT);
- Sickness or its medical or surgical treatment, including diagnosis;
- bacterial infection except through a wound accidentally sustained;
- operating or riding in any kind of aircraft except as a fare-paying passenger on a regularly scheduled commercial flight or as a passenger in a transport plane operated by the Military Airlift Command (MAC) of the United States of America;
- alcohol intoxication, as defined in the state where the incidence occurred (intoxication means that the blood alcohol level meets the legal presumption of intoxication under the law of the state where the accident took place);
- taking of any drug, medication, narcotic or hallucinogen, unless as prescribed by a Physician;
- voluntary gas inhalation or poison voluntarily taken, administered or inhaled (except in CT);
- riding or driving as a professional in any kind of race for prize money or profit (exclusion not applicable in CT).
Please note the following:
- The Repatriation Expense Benefit is not available in MI.
- The Special Training Benefit is not available in MN and PA.
Choice of Beneficiary
Your beneficiary can be anyone you choose. You may change your beneficiary at any time by written request. Payments for losses other than loss of life will be made to you. You are the beneficiary for dependent coverage.
Effective Date
Your coverage becomes effective on the date your application and premium are received by the Plan Representative.
How to Apply for Coverage
It is important to read the General Information section of this website before applying for coverage. Complete application instructions and the Plan application for the SPE High-Limit Accident Insurance Plan are available online.
The Plan is underwritten by Monumental Life Insurance Company, Cedar Rapids, IA.
Policy #MZ0100148/0000A
Certificate form #s
AD1000GCM
AD1000GCM.AR
AD1000GCM.CT
AD1000GCM.ID
AD1000GCM.KS
AD1000GCM.ME (Rev. 1/05)
AD1000GCM.NH
AD1000GCM.PA
* Loss means the death of the Covered Person or any physical impairment, incurred expense, or other benefit covered under the Terms of this Policy and any attached Riders. See Master Policy for complete details.