ACCIDENT AND SICKNESS

Policy Period: March 15, 2017 – March 15, 2018

The following outlines the coverages, exclusions and specifications of the Accident and Sickness Insurance policy. Please note that that some of the additional coverages have sub-limits and the information provided is only a summary of the benefits; the actual policy will govern. If your department, division, unit, etc. is interested in purchasing this insurance, please complete the below excel spreadsheet with the information of your camp. An example highlighted in yellow is shown on the spreadsheet. If you have any questions, please contact EH&S Risk Management.

Enrollment Form Microsoft Excel Document Icon


Covered Persons

  • All participants attending a camp or school, including sports activities, administered by the University for Accident or Emergency Sickness that results in bodily injury.

Coverage Territory

  • Accident or Sickness must have occurred on University campus or other location within 5 hours drive of the campus, as part of a Covered Activity; worldwide coverage for Medical Evacuation and Repatriation.

Benefits

  • Medical: usual and customary costs of inpatient hospital services (room and board, intensive care, inpatient labs and diagnostic tests, nurse services and physiotherapy), ambulatory medical center, emergency room treatment, physician services, outpatient services (lab and diagnostics tests, physiotherapy, and nursing services), ambulance services (air and ground), medical equipment rental, medical services and supplies, dental services and prescription drugs.

  • Medical Evacuation: usual and customary costs to transport Covered Person to nearest hospital or other medical facility, or to transport Covered Person to place of primary residence, if 100 miles away or more from location of Accident or Emergency Sickness, to be treated at a local hospital or other medical facility.

  • Repatriation: usual and customary costs to transport the remains of a Covered Person to their place of primary residence, if 100 miles away or more from location of the Accident or Emergency Sickness.

Exclusions – All Benefits

  • Intentionally self-inflicted injury or suicide; in commission of a felony; in commission of a riot or insurrection; declared or undeclared war; voluntary ingestion of any narcotic, drug, poison, gas or fumes, unless prescribe by physician; intoxication; while operating a motor vehicle if not properly licensed; aggravation of a previous injury; and cardiovascular event or stroke from exertion during Covered Activity.

Exclusions – Medical Benefits

  • Cosmetic surgery; elective or routine treatment, surgery, examination or service; examination or prescriptions for eyeglasses, hearing aids or braces; custodial care; repair to existing dentures, braces or bridgework; treatment for injuries which occur over time, such as blisters, tennis elbow, etc.; hernia; pre-existing conditions; and frostbite, fainting, seizures, heatstroke or heat exhaustion.

Benefit Amounts

  • Limits
    • Medical, Accidents only: $25,000
    • Medical, Emergency Sickness only: $2,500
    • Dental: $1,000
  • Deductible: $0
  • Benefit Period: 52 weeks from the date of the Covered Accident or Emergency Sickness
  • First Covered Expenses: must be incurred within 90 days after the Covered Accident or Emergency Sickness

Rates

Plan Options

Plan A
Primary
No Sickness
Plan B
Excess
No Sickness
Plan C
Primary
with Emergency Sickness
Plan D
Excess
with Emergency Sickness
Per Person Per Day/Night
– Non-Sports Camp
$0.14
$0.10
$0.35
$0.21
Per Person Per Day/Night
– Sports Camp
$0.27
$0.18
$0.61
$0.36
Per Person Per Day/Night
– Year Round
$0.014
$0.013
$0.022
$0.019

Definitions

  • Covered Activity: any activity sponsored and supervised by the University.

  • Accident: means a sudden, unexpected, specific and abrupt event that occurs by chance at an identifiable time and place during the policy period.

  • Emergency Sickness: means an illness or disease which causes severe or acute symptoms that would reasonably be expected to result in serious deterioration of the Covered Persons health, and first manifests itself suddenly and unexpectedly during the policy period and while the Covered Person is participating in a Covered Activity.

  • Primary: policy will pay benefits without regard to any other healthcare plan the Covered Person may have.

  • Excess: policy will only pay benefits when they are in excess of amounts payable by any other healthcare plan whether or not a claim has been made for the benefits it provides.

 

 

EHSA Log-In
Risk Management
Contacts

Main Phone: 407-823-6300
Fax: 407-823-0146

P.O. Box 163500
3540 Perseus Loop, Bldg. 16A Facilities and Safety
Orlando, FL 32816-3500

Blake LovvornAssistant Director
407-823-0206