sports
camp
martial
arts
dance
studio
baseball/softball
accident coverage
baseball/
softball
liability coverage
tackle
football
accident coverage
tackle
football
liability coverage
youth
sports
accident coverage
adult
sports
accident coverage
youth
/ adult
sports liability
day
care
youth
group
adult
group
special
events
Boxing
& Wrestling
Pro
Athlete
Insurance
JROTC
K-12/College
Fire Dept
LODD
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In the past, accident medical coverage for youth sports teams and leagues
was either too costly, too limited, or not available at all. Individuals
were either forced to pay extremely high insurance premiums or to run
teams and leagues without proper insurance protection, therefore running
the risk of personal exposure to lawsuits or a participant or staff member's
injury claim.
However, now a comprehensive program has been developed to specifically
cover the inherent risks involved for today's youth sports teams and leagues.
This Accident Medical Insurance Program is designed to help eliminate
the financial and emotional burden one can incur as a result of injury
in today's athletic arena.
The Accident Medical Coverage
Pays the medical bills of an injured participant or staff member
Who Is Covered
All participants of the Policyholder are covered while participating in
sponsored activities. A member is also covered while traveling, directly
and without interruption, to and from any Policyholder sponsored activity
and his or her home or place of residence.
Accidental Death & Dismemberment
If a covered injury results in any of the losses specified below within
one year after the date of the accident, the Company will pay the applicable
amount.
- Full Principal Sum for loss of life
- Full Principal Sum for double dismemberment
- 50% of the Principal Sum for loss of one hand, one foot or sight of
one eye
- 25% of the Principal Sum for loss of index finger and thumb of same
hand
If the Principal sum is payable, no indemnity will be paid for dismemberment.
In any event, the double dismemberment indemnity is the maximum amount
payable under this Benefit for all losses resulting from one accident.
Maximum Medical Expense Benefit
If the Covered Person incurs eligible expenses as the result of a covered
injury, the Company will pay the charges incurred for such expense within
52 weeks, beginning on the date of accident. Payment will be made for
eligible expenses not to exceed the Maximum Medical Expense Benefit, subject
to the applicable deductible amount (if any). The first such expense must
be incurred within 60 days after the date of the accident.
| Note: |
Excess Coverage. This plan does not cover treatment or service
for which benefits are payable under any other insurance or medical
service payment plan available to the insured. |
Exclusions and Limitations
This Plan does not cover any loss to or resulting from:
- Sickness or disease in any form, except pyogenic infections due to
an accidental cut or wound.
- The use of drugs or narcotics, unless administered under the advice
of a physician.
- War or any act of war, whether or not declared.
- Participation in any riot or civil commotion.
- Air travel or the use of any device or equipment for aerial navigation,
except as a fare-paying passenger on a regularly scheduled commercial
airline.
- Suicide or any attempt thereat or any self-inflicted injury.
Nor does the Plan cover:
- Service provided by any person or facility employed or retained by
the Policyholder or member organization.
- Service provided by any member of the Insured Person's family or household.
- Dental treatment, except as the result of a covered injury.
- The repair or replacement of any artificial dental restoration.
- Expenses payable under any Workers Compensation Law or similar legislation.
- Injury sustained while riding in or on any two or three wheeled engine
driven vehicle.
Premium Rates [Minimum
Policy: $150.00]
Following are the per participant premium rates.
(Policy term in months is shown after name of sport)
Rate
Class |
|
Rate
Class |
Archery (6)
Badminton (6)
Basketball (6)
Bowling (8)
Boxing (5)
Cheerleading (9)
Cross Country (6)
Fencing (6)
Field Hockey (5)
Flag Football (6)
Golf (6)
Gymnastics (6)
Touch Footbal (6)
Track (9) |
1
1
2
1
4
2
1
1
3
3
1
3
3
1 |
|
Handball (6)
Ice Hockey (5)
In-Line Skating (6)
Lacrosse (5)
Polo (5)
Rifle (6)
Rowing (6)
Rugby (6)
Skiing (4)
Soccer (5)
Swimming (9)
Tennis (8)
Volleyball (5)
Weightlifting (6)
Wrestling (6) |
1
4
4
4
4
1
1
4
4
3
1
1
2
3
3 |
| |
Class 1 |
Class 2 |
Class 3 |
Class 4 |
Maximum
Medical
Expense
Benefit |
AD&D
Benefit
(Principal
Sum) |
Deductible
Amount |
Age
12
and
Under |
Ages
12-14 |
Ages
16-18 |
Age
12
and
Under |
Ages
12-14 |
Ages
16-18 |
Age
12
and
Under |
Ages
12-14 |
Ages
16-18 |
Age
12
and
Under |
Ages
12-14 |
Ages
16-18 |
| $5,000 |
$2,500 |
$ -0-
25.00
50.00
100.00 |
1.90
1.65
1.45
1.25 |
2.15
1.90
1.65
1.50 |
2.75
2.40
2.15
1.90 |
2.60
2.20
1.95
1.75 |
2.90
2.50
2.20
1.95 |
4.75
4.10
3.60
3.30 |
2.70
2.45
2.20
1.95 |
3.00
2.75
2.45
2.20 |
4.85
4.55
4.05
3.60 |
4.95
4.70
4.45
4.10 |
7.80
7.55
7.25
6.55 |
12.20
11.85
11.35
10.20 |
| $10,000 |
$10,000 |
$ -0-
25.00
50.00
100.00 |
2.50
2.35
2.10
2.00 |
2.90
2.65
2.40
2.35 |
3.80
3.40
3.10
2.95 |
3.45
3.15
2.90
2.75 |
3.90
3.55
3.30
3.15 |
6.45
5.85
5.35
5.15 |
4.05
3.55
3.20
3.10 |
4.55
3.95
3.65
3.45 |
7.35
6.50
6.00
5.75 |
7.75
7.15
6.75
6.45 |
11.90
11.15
10.70
10.25 |
18.45
17.50
16.80
16.15 |
| $15,000 |
$10,000 |
$ -0-
25.00
50.00
100.00 |
2.65
2.45
2.36
2.20 |
3.00
2.85
2.65
2.50 |
3.90
3.65
3.40
3.03 |
3.65
3.40
3.20
3.00 |
4.10
3.80
3.60
3.40 |
6.75
6.25
5.85
5.60 |
4.30
3.80
3.55
3.40 |
4.80
4.20
3.95
3.85 |
7.80
6.95
6.55
6.25 |
8.40
7.70
7.35
7.05 |
12.95
12.15
11.80
11.30 |
20.50
19.30
1845
17.65 |
| $25,000 |
$10,000 |
$ -0-
25.00
50.00
100.00
250.00 |
2.90
2.70
2.60
2.40
2.00 |
3.30
3.15
2.90
2.75
2.30 |
4.30
4.00
3.75
3.60
3.00 |
4.00
3.75
3.50
3.30
2.80 |
4.50
4.15
3.95
3.75
3.15 |
7.40
6.85
6.40
6.15
5.15 |
4.75
4.15
3.90
3.75
3.15 |
5.30
4.60
4.35
4.20
3.55 |
8.55
7.60
7.20
6.85
5.75 |
9.30
8.65
8.05
7.70
6.45 |
14.65
13.70
12.95
12.40
10.40 |
22.75
21.40
20.20
19.35
16.25 |
| League Discounts |
4 thru 10 Teams
5% Discount |
11 thru 20
6% Discount |
21 thru 35
7% Discount |
36 thru 50
8% Discount |
51 & Over
10% Discount |
Age Classification — if more than 10% of the players on a team exceed the maximum age in the
age classification, then the next higher classification must be used.
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