Group Accidental Death and Dismemberment

Group Accidental Death and Dismemberment  

Overview

Accidents Do Happen

No one plans to have a serious accident, so when one happens the financial consequences can be devastating. The MSBA Accidental Death & Dismemberment (AD&D) Plan gives you broad accident coverage, 24 hours a day, worldwide. You're covered at home, at work, on vacation, on the road, for practically every activity. See the exclusions section for more information.

Choose a minimum of $50,000 to a maximum of $500,000 in increments of $25,000. This is worldwide, 24-hour-a-day coverage that pays in addition to any other insurance you may have. All members under age 70 will automatically be accepted into this plan.

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Enrollment Form

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ENROLLMENT FORM

 

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Family Coverage

Your spouse/domestic partner and dependent children under age 25 are also guaranteed coverage. Your spouse/domestic partner benefits are 40% of the benefit amount you choose and dependent child(ren)'s benefits are 10% of your benefit. If no spouse/domestic partner coverage is elected, each dependent child's coverage is 15% of your benefit. If no child coverage is elected, your spouse's/domestic partners benefits are 50% of your coverage.

Take a look at the enrollment form and brochure under the "Forms" tab for information on additional benefits such as:

  • Safe Driver Benefit
  • Education Benefits
  • Child Care Benefits Paid To Your Family
  • Coma Benefit
  • Common Carrier Benefit
  • Total And Permanent Disability
  • Training Benefit
  • Elder Care Benefit
  • Expose and Disappearance Benefit
  • Transportation Benefit
  • Burn Disfigurement Benefit
  • Rehabilitation Benefit
  • Common Disaster Benefit


Below is the plan's rate chart
:

Member's Benefit Amount Member Monthly Premium Contributions Member & Family Monthly Premium Contributions
$50,000 $2.70 $3.75
$75,000 $4.05 $5.63
$100,000 $5.40 $7.50
$125,000 $6.75 $9.38
$150,000 $8.10 $11.25
$175,000 $9.45 $13.13
$200,000 $10.80 $15.00
$225,000 $12.15 $16.88
$250,000 $13.50 $18.75
$275,000 $14.85 $20.63
$300,000 $16.20 $22.50
$325,000 $17.55 $24.38
$350,000 $18.90 $26.25
$375,000 $20.25 $28.13
$400,000 $21.60 $30.00
$425,000 $22.95 $31.88
$450,000 $24.30 $33.75
$475,000 $25.65 $35.63
$500,000 $27.00 $37.50


Rates do not increase with age. Rates shown are guaranteed until June 30, 2024. For your convenience, you will be billed annually. If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment options.

Exclusions:

ReliaStar Life does not pay benefits for loss directly or indirectly caused by any of the following:

  • An accident occurring before the Effective Date of the Group Policy.
  • Suicide or intentionally self-inflicted injury, while sane or insane.
  • Physical or mental illness.
  • Bacterial infection or bacterial poisoning. Exception: Infection from a cut or wound caused by an accident or accidental indigestion of a poisonous food substance.
  • Any armed conflict, whether declared as war or not, involving any country or government.
  • An accident that occurs while in the military service for any country or government.
  • An accident that occurs when the insured person commits, or attempts to commit, a crime.
  • Voluntary use of any drug, medication, or sedative unless -
       - prescribed by a doctor and
       - taken as directed by a doctor or the manufacturer.
  • Driving or operating a motor vehicle while intoxicated. Intoxicated means your blood alcohol content meets or exceeds the legal presumption of intoxication under the laws of the state where the accident occurred.

 

How to Enroll?

Complete, date and sign the Enrollment Form and return with your premium check payable to:
   MSBA Group Insurance Program
   P.O. Box 14533
   Des Moines, IA 50306
or email to:
[email protected]

 

Consider Your Eligibility

Before you enroll for coverage, you must be a member in good standing of MSBA. You must be a member for 30 days before initiating your insurance request. If you have any questions about membership, see the MSBA home page.

 

Questions? We're only a phone call away.

If you have questions about your eligibility, call a service representative toll-free at 1-800-501-5776 between 7:30 a.m. and 5 p.m. Central Time, Monday through Friday.

 

About This Plan Information

This is a summary of benefits only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of coverage. All coverage is subject to the terms of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern.

Accidental Death and Dismemberment insurance coverage is provided under the terms of a group life insurance policy, Group Policy 29063-7 issued and delivered in the state of Minnesota, and governed by its laws, to the Minnesota State Bar Association as the policyholder. The group life insurance policy is issued by ReliaStar Life Insurance Company, Minneapolis, Minnesota. The policy is administered on behalf of ReliaStar Life Insurance Company by AMBA Administrators, Inc., an insurance administrator licensed in the state of Minnesota. Policy Form LP08GP.

This is a paid endorsement. The MSBA receives a fee from the insurance broker and/or the insurer for its endorsement of this plan.

 

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Contacts

Program Administrator

 Address
AMBA Administrators, Inc.
Customer Service
PO Box 14533
Des Moines, IA 50306
 Phone
1-800-501-5776
 Hours
 M-F 7:30a-5p CT
 Email
[email protected]

 

Insurance Company:

ReliaStar Life Insurance Company
Minneapolis, MN