Accident
School System offers an accident plan to protect you from unexpected non-occupational accidents, as it can be difficult to financially plan for the unexpected. This plan provides a benefit payable according to a schedule, and the funds may be used for any purposes, including helping to pay for medical out-of-pocket costs like deductibles and coinsurance.
This plan reimburses you for your actual medical expenses and the benefit is paid directly to you. Coverage options are available for you, your spouse, and your dependent child(ren). It also includes a benefit for death, loss of limbs, hospital visits, and transportation by ambulance – as a result of a covered accident. Reference the plan summary below for more details.
| Injury | Benefit |
|---|---|
|
Hospital Care
|
|
| Surgery - Open abdominal, thoracic | $1,000 |
| Blood, plasma, platelets | $500 |
| Admission | $1,125 |
| Confinement | $350 / day up to 365 days |
| Transportation | $650 / trip up to 3 per accident |
| Lodging | $150 / day up to 30 days |
|
Accident Care
|
|
| Initial doctor visit | $75 |
| Urgent care | $200 |
| Follow-up doctor treatment | $75 |
| Medical equipment | $100 |
| Speech & physical therapy | $40 up to 6 per accident |
| X-Ray | $40 |
|
Common Injuries
|
|
| 2nd and 3rd degree burns | $1,125 to $12,500 |
| Emergency dental work | $75 to $300 |
| Eye injury | $80 to $275 |
| Torn knee cartilage | $175 to $650 |
| Lacerations | $25 to $400 |
| Tendon, ligament, rotator cuff | $350 to $1,000 |
| Concussion | $175 |
| Paralysis | $13,500 to $20,000 |
|
Injuries - Dislocations
|
Non-surgical | Surgical |
| Hip joint | $3,200 | $6,400 |
| Knee | $2,000 | $4,000 |
| Ankle or foot bones (other than toes) | $1,200 | $2,400 |
| Shoulder | $1,500 | $3,000 |
| Elbow, wrist | $900 | $1,800 |
| Finger | Toe | $250 | $500 |
| Hand bones, lower jaw, collarbone | $900 | $1,800 |
| Partial dislocations | 25% of the non-surgical benefit |
|
Injuries - Fractures
|
Non-surgical | Surgical |
| Hip | $2,500 | $5,000 |
| Leg | $1,800 | $3,600 |
| Ankle, forearm, hand, wrist | $1,500 | $3,000 |
| Collarbone | $1,200 | $2,400 |
| Rib(s) | $350 | $750 |
| Shoulder | $1,500 | $3,000 |
|
Sports Accident Benefit
|
|
| Covers accident as a result of an organized sporting activity | Pays an additional 25% of the Hospital Care, Accident Care, or Common Injuries to a maximum benefit of $1,000 |
Important Notes
- Employees are eligible regardless of age
- Spouses age 70 and older are not eligible to elect coverage
- Coverage for eligible child dependent(s) is up to age 26
Exclusions
All sicknesses including pregnancy, work-related injuries, services not medically necessary, being intoxicated in accordance with state laws, alcoholism, voluntary inhalation of gas/fumes/taking of poison, driving in any race or speed test or while testing an automobile or vehicle on any racetracks or speedway, injury while skydiving, hang gliding, parachuting, scuba diving, rodeo, or aviation except flight in a scheduled passenger aircraft, being under the influence of a narcotic/drug, intentionally self-inflicted injury, hernia, carpel tunnel syndrome, or any complication therefrom, bacterial infections.
Sports Accident Coverage
The Accident plan pays an additional 25% of the Hospital Care, Accident Care, and Common Injuries benefits to a maximum of $1,000 if the covered accident is a result of an organized sporting activity.
