Compare Benefits (Plan A vs. B)

Plan A provides superior benefits with higher limits and lower deductibles.

Plan A
Plan B
Accident Medical Expense Benefits
Deductible Amount $100 $200
Combined Single Limit (CSL) Per Covered Loss $500,000 $400,000
Aggregate Limit of Liability $1,000,000 $800,000

(Applicable to all Covered Losses from any one Occupational Accident)

Death & Catastrophic Injury Benefits
Accidental Death Benefit
Principal Sum* $50,000 $25,000
Accident Commencement Period 365 Days
Survivor’s Death Benefit
Principal Sum* $100,000 $75,000
Monthly Benefit Amount $1,000 $750
Accidental Dismemberment Benefit
Principal Sum* $150,000 $100,000
Accident Commencement Period 365 Days
Paralysis Benefit
Principal Sum* $150,000 $100,000
Accident Commencement Period 365 Days
Temporary Total Disability Benefit
Disability Commencement Period 90 Days 90 Days
Waiting Period 7 days 10 days
Benefit Percentage of Prior Earnings 70% 66.66%
Minimum Weekly Benefit Amount $125 $125
Maximum Weekly Benefit Amount $500 $400
Maximum Benefit Period** 104 Weeks 104 Weeks
Continuous Total Disability Benefit
Waiting Period 104 Weeks 104 Weeks
Benefit Percentage of Prior Earnings 70% 66.66%
Minimum Weekly Benefit Amount $50 $50
Maximum Weekly Benefit Amount $500 $400
Maximum Benefit Amount $100,000 $100,000
Maximum Benefit Period*** To Age 70 To Age 70
Accident Medical Expense Benefit
Medical Commencement Period 90 days 90 days
Deductible Amount $100 $100
Maximum Benefit Period 104 weeks 104 weeks
Payments to Preferred Providers $500 $400
Payments to Non-Preferred Providers 100% of Usual and Customary Charge(s)
(in no event will payment be less than 80% of the minimum rate paid to a Preferred Provider)
Dental Maximum per Accident $2,500 $2,500
Maximum Benefit Amount per Accident $500,000 $400,000
Lifetime Maximum Benefit $500,000 $400,000
Limits on Accident Medical Expense Benefits
Physical Therapy, Occupational Therapy, Work Hardening Therapy, no individual limit, but as any medical service, it is subject to the Accident Medical Expense Benefit, the Combined Single Limit and the Aggregate Limit of Liability stated in the Policy for Occupational Accident Benefits.
Services provided by a Chiropractor or Acupuncturist, not including Physical Therapy, Occupational Therapy, Work Hardening Therapy (Per Injury) $1,000 $1,000
Ambulance – one round trip to and from a Hospital (but not more than $1,000 for any one Accident) $1,000 $1,000
Air Ambulance – one round trip to and from a Hospital (but not more than $7,000 for any one Accident) $7,000 $7,000
Mental and Nervous – Outpatient per visit (maximum 20 visits for any one Accident) $25 $25
Mental and Nervous – Inpatient (maximum 25 Days) $1,000 $1,000

Notes:
The Accidental Dismemberment Benefit and the Paralysis Benefit will be paid as a Monthly Benefit at 1% of the applicable Principal Sum. The payment of this Monthly Benefit will cease upon the earliest of the following: (1) the date the total of the applicable Principal Sum has been paid; or (2) the date You die. The most the insurer will pay for this benefit, as well as the Accidental Death Benefit, in total, is Your maximum Principal Sum if You can recover benefits under more than one of the benefits as a result of the same Accident.

At age 65, Your Principal Sum will be based on the following schedule:
For Death and Survivor Benefits, Age at Date of Covered Loss

For Dismemberment and Paralysis Benefits,
Age at Date of Benefit Payment
% of Principal Sum
65 80%
66 60%
67 40%
68 20%
69 15%
70 and over 10%

** If You sustain a Covered Injury at or after age 70, the Maximum Benefit Period will be one (1) year.

*** If You sustain a Covered Injury after Your normal Social Security retirement age, as determined by federal law, You cannot qualify for Continuous Total Disability.

OneBeacon Insurance Group