Product Review

Covered Medical Expenses

Hospital room and board expenses: the daily room rate when a Covered Person is Hospital Confined and general nursing care is provided and charged for by the Hospital. In computing the expenses payable under this benefit, the date of admission will be counted, but not the date of discharge.

Ancillary Hospital expenses: services and supplies including operating room, laboratory tests, anesthesia and medicines (excluding take home drugs) when Hospital Confined.

Medical emergency care (room and supplies) expenses incurred within twenty-four (24) hours of an Accident and including the attending Physician's charges, X-rays, laboratory procedures, use of the emergency room and supplies.

Outpatient surgical room and supply expenses for use of the surgical facility.

Outpatient diagnostic X-rays, laboratory procedures and tests.

Physician non-surgical treatment/examination expenses (including medicines) including the Physician's initial visit, each necessary follow-up visit and consultation visits when referred by the attending Physician.

Physician's surgical expenses: If a Covered Injury requires multiple surgical procedures through the same incision, Zurich American Insurance Company will pay only one benefit, the largest of the procedures performed.

If multiple surgical procedures are performed during the same operative session but through different incisions, Zurich American Insurance Company will pay for the most expensive procedure.

Assistant physician expenses when Medically Necessary.

The Medically Necessary services of a registered nurse not Related to the Covered Person.

Anesthesiologist expenses for pre-operative screening and administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis.

Outpatient laboratory test expenses.

Physiotherapy expenses on an inpatient or outpatient basis limited to one (1) visit per day to a maximum of twelve (12) visits. Expenses include treatment and office visits connected with such treatment when prescribed by a Physician, including diathermy, ultrasonic, whirlpool, or heat treatments, adjustments, manipulation, massage or any form of physical therapy.

X-ray expenses (including reading charges) but not for dental X-rays unless Medically Necessary to evaluate a Covered Injury.

Radiological procedures.

Diagnostic imaging expenses including Magnetic Resonance Imaging (MRI) and Computed Axial Tomography (CAT) Scan.

Ambulance expenses for transportation from the emergency site to the Hospital (excluding air ambulance).

Rehabilitative braces or appliances prescribed by a Physician. It must be durable medical equipment that: is primarily and customarily used to serve a medical purpose; can withstand repeated use; and generally is not useful to a person in the absence of injury. No benefits will be paid for rental charges in excess of the purchase price.

Prescription drug expenses, for Covered Injuries, prescribed by a Physician and administered on an outpatient basis.

Medical equipment rental expenses for a wheelchair or other medical equipment that has therapeutic value for a Covered Person. Zurich American Insurance Company will not cover computers, motor vehicles or modifications to a motor vehicle, ramps and installation costs, eyeglasses and hearing aids.

Expenses for blood and blood transfusions; oxygen and its administration.

MEwellnessprogram

This benefit plan includes access to MEwellnessprogram benefits. MyEWellness.com will provide you with comprehensive information in a simple and straightforward way. We want to help you achieve your own personal health and fitness goals no matter how old you are even if you’ve never exercised before and have no access to workout equipment. As an added convenience, you’ll have the ability to take your personalized exercise and nutrition program with you on your mobile phone!

MyEWellness.com is not intended to be a substitute for professional health care, but will provide you with the following: Unbiased information to assist you in sorting out fact from fiction. Means to determine your individual fitness level and prescribe appropriate exercise. Fitness programs that can benefit each age group. Extensive exercise library with easy to follow video demonstrations specifically designed for home workout programs. Preventive strategies to treat common muscle dysfunctions. Proper exercise progressions, which improve strength, endurance, and flexibility. Preventative exercise programs, the cornerstone for overall health.

Coordination of benefits

The accident medical benefits are excess of other coverage and will coordinate with other insurance. Zurich American Insurance Company will pay the usual and customary amount, reduced by any other insurance plan and the deductible amount, up to the maximum amount selected in your enrollment. In no event will Zurich American Insurance Company pay more than the maximum amount stated in your certificate of coverage. If no in force policy exists, the policy will pay benefits on a primary basis and a deductible of $100 will apply.

Exclusions and Limitations

 GENERAL EXCLUSIONS

suicide or any attempt at suicide or intentionally self-inflicted Covered Injury or any attempt at intentionally self-inflicted injury.

war or any act of war, whether declared or undeclared. involvement in any type of active military service.

illness or disease, regardless of how contracted, medical or surgical treatment of illness or disease; or complications following the surgical treatment of illness or disease; except for Accidental

ingestion of contaminated foods.

participation in the commission or attempted commission of a crime, any felony, an assault, insurrection or riot.

being intoxicated. A Covered Person will be conclusively presumed to be intoxicated if the level of alcohol in his or her blood exceeds the amount at which a person is presumed, under the law of the locale in which the Accident occurred, to be intoxicated, if operating a motor vehicle. An autopsy report from a licensed medical examiner, law enforcement officer reports, or similar items will be considered proof of the Covered Person's intoxication.

being under the influence of any prescription drug, controlled substance, or hallucinogen, unless such prescription drug, controlled substance, or hallucinogen was prescribed by a Physician and taken in accordance with the prescribed dosage.

travel or flight in any aircraft except as a fare-paying passenger on a regularly scheduled charter or commercial flight.

release, whether or not Accidental, or by any person unlawfully or intentionally, of nuclear energy or radiation, including sickness or disease resulting from such release.

a cardiovascular event or stroke caused by exertion prior to or at the same time as an Accident.

any condition for which the Insured is entitled to benefits under any Workers' Compensation Act, No Fault Auto Coverage or similar law.

In addition to the General Exclusions, Zurich American Insurance Company will not cover expenses under the Accident Medical Expense Benefit for: Cosmetic, plastic or restorative surgery unless Medically Necessary for the treatment of the Covered Injury.

Any medical expenses related to pregnancy unless Medically Necessary for the treatment of the Covered Injury.

Any expenses for a Pre-existing Condition.

Covered Injury for which the Covered Person is entitled to benefits under Workers Compensation Benefits, Employer Liability Law, or other similar law.

Personal comfort or convenience items, such as but not limited to Hospital telephone charges, television rental, or guest meals.

Treatment by any person Related to the Covered Person.

Expenses incurred for dental care, treatment, repair or replacement of sound natural teeth unless Medically Necessary for the treatment of the Covered Injury.

Expenses incurred for eye examinations, eye glasses, contact lenses or hearing aids or the fitting, repair or replacement of these items unless Medically Necessary for the treatment of the Covered Injury.

A hernia.

Routine physical examinations and related medical services, elective treatment of surgery, experimental or investigative treatments or procedures.

A Medical Repatriation.

Expenses incurred for psychological or psychiatric counseling of any kind or any expense for treatment of mental or nervous diseases or disorders.

Expenses which the Covered Person is not legally obligated to pay.

Expenses for Custodial Services or services provided by a private duty nurse unless such expenses are incurred as a result of the Covered Injury.

Expenses related to the repair or replacement of existing artificial limbs, eyes, or other prosthetic appliances, or rental of existing medical equipment unless for the purpose of modifying the item because the Covered Injury has caused further impairment in the underlying bodily condition.

Treatment involving conditions caused by repetitive motion injuries or cumulative trauma and not a result of a Covered Injury.

Treatment of Osgood-Schlatter's Disease.

GENERAL LIMITATIONS

Limitation on Multiple Covered Losses. If a Covered Person suffers more than one Covered Loss as a result of the same Accident, Zurich American Insurance Company will pay only one benefit, the largest benefit.

Limitation on Multiple Coverages and Benefits. If a Covered Person can recover benefit under more than one of the Coverages or Benefits as stated in the schedule as a result of the same Accident, the most Zurich American Insurance Company will pay for these benefit in total is the Covered Person's Principal Sum.

Disclaimers

THIS IS LIMITED ACCIDENT MEDICAL EXPENSE INSURANCE. IT IS AN ACCIDENT ONLY POLICY AND DOES NOT COVER LOSS OR EXPENSE RESULTING FROM SICKNESS, DISEASE, OR BODILY INFIRMITY. T

HIS IS NOT TRADITIONAL HEALTH INSURANCE.

THIS OFFER INCLUDES DISCOUNTS AND/OR SERVICES PLUS ADDED LIMITED BENEFIT MEDICAL AND ACCIDENT INDEMNITY INSURANCE.

NONE OF THESE, INDIVIDUALLY OR IN COMBINATION ARE A SUBSTITUTE FOR TRADITIONAL HEALTH INSURANCE, MAJOR MEDICAL INSURANCE, MEDICARE, A MEDICARE SUPPLEMENT, OR ANY OTHER MEDICAL EXPENSE REIMBURSEMENT INSURANCE PLAN.

The benefit amount for the Accident Medical Benefit is payable in excess of any in force policy. In the event and only in the event of the reduction or exhaustion of the limit of insurance of the in force policy solely as the result of actual payments of benefits covered thereunder, this policy shall pay excess of the reduced limit of insurance of the in force policy. This policy shall only pay pursuant to the terms and conditions of this policy and no other policy.

Zurich American Insurance Company will pay the Usual and Customary amount, reduced by any other insurance plan and the deductible amount, up to the maximum amount selected in your enrollment. In no event will Zurich American Insurance Company pay more than the maximum amount stated in your certificate of coverage.

If no in force policy exists, this policy will pay benefits on a primary basis and a deductible of $100 will apply to such benefit.

All benefits provided by this insurance are subject to the terms, definitions, conditions, exclusions, and limitations, of the group policy. To obtain more information about this benefit, please call 1-800-880-1276. The insurance benefits are underwritten by Zurich American Insurance Company and issued to NACD. Coverage is not provided for loss due to a pre-existing condition. The underwriting risks, financial obligations and support functions associated with the products issued by Zurich American Insurance Company are it's responsibility. Zurich American Insurance Company is responsible for its own financial condition and contractual obligations.

This material is designed for informational purposes only and merely summarizes the benefits available. All benefits are subject to the contracts, master group insurance policy and any amendment which alone constitutes the agreement.

Pros

Zurich American Insurance Company has a strong consumer reputation that adds to the popularity of this insurance.

The coverage is very affordable; rates start at $20 per month for single coverage. The highest benefit level family coverage is typically only $55 per month (plus about $5 association fee). Below is a sample rate and benefit chart (your rates may be different so see the quote link for actual rates):

Upgrade Option	Accident Medical1	AD&D2	Upgrade Price3
$2,500 - Member Only:	$2,500	$5,000	$20.00
$2,500 - Member + Family:	$2,500	$5,000	$30.00
$5,000 - Member Only:	$5,000	$10,000	$25.00
$5,000 - Member + Family:	$5,000	$10,000	$35.00
$7,500 - Member Only:	$7,500	$25,000	$35.00
$7,500 - Member + Family:	$7,500	$25,000	$45.00
$10,000 - Member Only:	$10,000	$50,000	$45.00
$10,000 - Member + Family:	$10,000	$50,000	$55.00

¹ Coverage amounts indicated are per occurrence (accident). The first treatment of service must occur within ninety (90) days of the Covered Injury and the medical expenses must be injured within fifty-two (52) weeks of the Covered Injury. See the definitions, exclusions and limitation for details.

² The Accidental Death and Dismemberment amount for covered dependents will be a percentage of the member's AD&D amount on the date of the accident. Spouse/Domestic Partner AD&D amount is equal to 40% of the member's AD&D amount. Dependent child(ren) AD&D amount is equal to 10% of the member's AD&D amount.

³ Enrollment in the NACD Advantage Membership is required to enroll in the Protection Membership Upgrade. Pricing indicated is monthly. Membership pricing is subject to change.

NACD membership includes a travel medical notification service, a telemedicine service and a consumer purchase discount program.

Cons

Unlike otherwise similar supplemental accident insurance, this policy has a "coordination of benefits" clause to keep the cost low. That means that you cannot collect more than 100% of the medical expenses you incur from all of your insurance combined. In contrast, a supplemental policy that does not coordinate allows you to "collect twice" on the same medical bill and therefore use the money for another purpose like loss of income during that period of time.

Forms in PDF format for download

This insurance uses direct online enrollment; no paper application is provided. All available forms and enrollment materials can be found by following the quote and enrollment link above.

News

January 2, 2013 - The plan administrator reports that some members have run into unnecassary difficulties because they do not recognize the charge on their bank statements listed as "NACD Dues" in connection with their enrollment in this benefit. A member who does not recognize the ACH charge may instruct their bank to reject or deny the payment transaction. This causes all member benefits to be suspended until the payment problem is resolved. The problem can be avoided simply by notifying members that the charge will appear on their bank statements as "NACD Dues".