Special Risk Program (Countrywide)
Applications, Forms, & Brochures
- Availability
- Eligibility
- Who is Covered?
- When Are They Covered?
- Description of Coverages
- Plans
- Excess Coverage
- General Exclusions and Limitations
- Underwriting
- Cancellation
- Program Supplement
- Additional Information Pertaining to Program Supplement
- Print this Page
Availability
This section is applicable for all states (except New York) where the Enhanced Special Risk has not been approved. (Maine, Vermont, Connecticut, Maryland, Washington, Montana, South Carolina, Florida, Kansas)
For New York, refer to the New York Special Risk program.
This program is not available in all states. State exceptions may apply.
Eligibility
See Underwriting Section and the Special Risk Accident Program Supplement.
Who is Covered?
All members of the group or organization and in some instances all instructors/supervisors are covered, subject to the terms of the policy.
When Are They Covered?
Coverage under the Special Risk policy is tailored
to meet the needs of the organization involved. Generally, members and
supervisors are covered while participating in or supervising activities
sponsored by the organization. In many cases business travel accident and individual
travel coverage to and from the activities may also be included.
Description of Coverages
Accidental Death – Pays the maximum benefit selected for loss of life resulting from a covered accident.
Accidental Dismemberment – Pays the maximum benefit selected for loss of both hands, both feet, or sight of both eyes; one hand and one foot; hand or foot and sight of one eye.
Pays one-half the maximum benefit for loss of one hand, one foot, or sight of one eye.
Pays one-quarter the maximum benefit for loss of thumb and index finger of either hand.
Death or dismemberment losses must occur within 180 days of a covered accident. (There is no time limit for loss of life in Pennsylvania.) If more than one loss is sustained under the Accidental Death and the Accidental Dismemberment Benefits, only one amount, the largest applicable, will be payable. The Accidental Death and Dismemberment Benefits can only be purchased in conjunction with the Accident Medical Expense or Weekly Accident Total Disability Benefit.
Accident Medical Expense – Pays incurred expenses for necessary medical or surgical treatment, services or supplies if the first expense is incurred within 26 weeks of the date of accident. For any one accident covered expenses will be paid up to the maximum amount of the plan selected if they are incurred within two years of the date of accident. However, the maximum dental expense limit for each accident is $250.00. (The Dental Expense Limit for Groups #10 and #11 is $1,000.)
Excess coverage is available in all states except Delaware and Oregon. In Nebraska, excess coverage is available for student accident coverage only (grades k through college). Excess coverage is not available to Group #11 (Project Head Start programs).
Excess coverage rates listed in this section are applicable to Group #10 only. In Illinois, different rates apply. Please contact your reporting office for details.
Weekly Accident Total Disability – Available only to organizations whose members (and instructors/ supervisors if covered) are otherwise gainfully employed. Pays the weekly benefit selected if an insured person is totally disabled and unable to work as the result of a covered accident. Total disability must commence within 30 days of such accident. Covers up to two years while the insured is unable to work at his usual occupation. It can be purchased with a cost-saving waiting period. This benefit will be written only in conjunction with the Accidental Death and Dismemberment or Accident Medical Expense benefit.
Plans
Benefit plans may be selected to meet the needs of each individual organization. The minimum and maximum benefit amounts which may be written under this program read as follows:
| Benefit | Minimum | Maximum | |
|---|---|---|---|
| Accidental Death | $500 | $15,000 | |
| Accidental Dismemberment | $500 | $15,000 | |
| Accidental Medical Expense | $500 | $10,000* | |
| Weekly Accident Total Disability | $10/week | $100/week | |
| Period Payable | 13 weeks | 2 years | |
| Waiting Period | none | 180 days | |
*The Maximum Accident Medical Expense for Groups #10 and #11 is $25,000.
In many cases, an underwriting restriction will not permit offering the above maximums. An attempt should always be made to keep benefits at a reasonable level in accordance with actual needs of the group. Vermont insurance statutes mandate a minimum $5,000 AD&D benefit. Contact your reporting office for details.
Plans and rates for certain specified groups are listed in the following Special Risk Accident Program Supplement. Plans and rates for other groups eligible for this program may be obtained from the Home Office by request through your reporting office. Each case submitted will be underwritten and rated in accordance with the nature of the group.
Excess Coverage
In certain states, lower rates are available if the Medical Expense portion of The Hartford’s Special Risk Accident Insurance is purchased on an “excess” basis. This means that after the Insured Person has been reimbursed for medical expenses by other insurance programs, The Hartford will pay up to the maximum Medical Expense for remaining treatment, service and supply expenses. Those other programs include group, blanket or franchise health insurance coverage, group hospital or medical service plans, and prepayment coverage; any coverage under labor management trustee plans, union welfare plans, employer organization plans, and coverage under governmental programs, coverage required or provided by any statute, and automobile reparations insurance (no-fault) coverage.
This provision, or its applicable state variation, is available in all states except Delaware. Excess coverage is available in Oregon on a limited student accident only basis.
Please note that any amounts paid by another Insurance “program” as defined above (or applicable state variation) cannot be used to satisfy any deductible under our policy.
General Exclusions and Limitations
The policy does not apply to: a) intentionally self-inflicted injury, suicide or attempted suicide, whether sane or insane; b) injury sustained while in or on, boarding or alighting from, being struck or run down by, any aircraft in motion except as an airline passenger on an aircraft operated by a passenger airline or on a regularly scheduled trip over its established route; c) war or act of war whether declared or not; d) injury sustained while in the armed forces (land, water or air) – of any country or international authority; e) repair or replacement of existing dentures, partial dentures, braces, fixed or removable bridges, or other artificial dental restoration; f) repair or replacement of artificial limbs or orthopedic braces; g) repair, replacement, examination for prescription or fitting of eyeglasses or contact lenses.
Additional exclusions for the Institutions of Higher Learning Program include: h) playing in all intercollegiate, interscholastic, or professional sports, including any interschool club sports, intramural sports, and participation in any form of tackle football; i) benefits under any Workers’ Compensation or similar law; j) expenses incurred for any treatment, services or supplies, or facilities provided by the health service or infirmary of the policyholder or by any physician or nurse employed or retained by the policyholder; k) expenses incurred which are covered under any automobile reparations insurance (no-fault) or automobile medical payments coverage, where permitted.
Underwriting
All quotations for organizations to be covered under the Special Risk Accident program, will be processed through your reporting office.
Complete and return the applicable request form or the applicable Special Risk marketing brochure along with any other information you feel may be helpful in underwriting the case. Pay particular attention to the following factors:
- Be certain the group is eligible under applicable state laws – if in doubt, contact your reporting office.
- Coverage is compulsory for all eligible members of a group to be insured.
- Experience of participants and supervisors as well as type and frequency of activity will affect the rate.
- Individual travel coverage to and from activities is available to many eligible groups and it will affect the rate.
- If coverage has been provided previously by another carrier, premium and loss information for the past 3 years must accompany the Request for Insurance form.
All members (and all instructors/ supervisors if eligible) of a group must be included in the policy. No name lists are required, but a premium must be paid for each person to be insured. New members joining the group while the policy is in effect will be covered automatically until the policy expiration date – WITHOUT ADDITIONAL CHARGE. The total premium for the policy is payable when insurance becomes effective. No refunds will be made for members who leave the group before the policy period expires.
No Special Risk policy will be written for less than $310. The minimum premium for each policy will be determined in accordance with the size, nature and financial status of the group involved and is non-refundable in the event the Policyholder cancels the policy after the effective date. In addition, a deposit premium must be paid upon issuance of any policy written on an audit premium basis.
Cancellation
The Policyholder may cancel the policy upon written notice at any time (except in North Carolina and West Virginia where there is no right of cancellation). The Company may cancel the policy upon five-days written notice (except in North Carolina and West Virginia where there is no right of cancellation, or in New Jersey for policies issued for a period of less than 11 months). In California, the Company may cancel the policy upon thirty-one days written notice.
Program Supplement
The programs listed below have been developed to enable you to present “on-the-spot” quotations for many of the more common groups insured under this program.
Eligible Groups and Scope of Coverage - Groups 1-15
| Group No. | Eligible Groups | Who is Covered | When They Are Covered |
|---|---|---|---|
| 1 | Adult Church Groups (See Additional Information section), Amateur Chorus, Choir and Concert Groups, Amateur Glee Clubs | All members of the policyholder. | While participating in activities sponsored and supervised by the policyholder, including traveling with a group in connection with such activities. |
| 2 | Chamber of Commerce, Exchange, Jaycee, Kiwanis, Lions, Optomists, Rotary, Sertoma | All members of the policyholder. | While participating in activities sponsored and supervised by the policyholder, including traveling with a group in connection with such activities. |
| 3 | Amateur Theater (adult or children) | All participants in the activities sponsored by the policyholder. | While participating in activities sponsored and supervised by the policyholder, including traveling with a group in connection with such activities. |
| 4 | Baton Twirlers, Drill Team,Drum and Bugle Corps, Marching Band, Marching Groups | All members of the policyholder. | While participating in activities sponsored and supervised by the policyholder, including traveling with a group in connection with such activities. |
| 5 | Volunteer Hospital Workers (Candy Stripers, Gray Ladies and Red Cross) | All members of the policyholder. | While participating in volunteer activities sponsored and supervised by the policyholder, on the premises of the hospital to which the insured person is assigned. |
| 6 | Civil Defense | All members of the policyholder. | While on duty under the supervision of the policyholder or while participating in fund-raising drives, training classes, test, drills, or trials of a piece of apparatus directly connected with such activities. |
| 7 | Vacation Bible School. Teachers may be insured, but if so, must all be included. | All registered full-time students(and teachers) of the policyholder. | While participating in activities sponsored and supervised by the policyholder or while traveling with a group in connection with such activities. |
| 8 | Soapbox Derbies. Adult supervisors may be insured, but if so, all must be included. | All participants in (and adult supervisors of ) the Soapbox Derby sponsored by the policyholder. | While participating in (or supervising) the Soapbox Derby sponsored by the policyholder, on the premises designated by the policyholder. |
| 9 | Adult Study Seminar, Beauty Contest, Fashion Show, Hay Ride, Outing, Parade, Picnic. | All participants in the activities (bystanders, spectators, and onlookers will not be included). | While participating in the activities sponsored and supervised by the policyholder and on the premises designated by the policyholder. Travel to and from the activity will not be included. |
| 10 | Nursery Schools, Kindergartens and Day Care Centers. Teachers and Supervisors may be insured, but if so, all must be included. | All registered full-time students or enrollees (and teacher and supervisors) of the policyholder. | While participating in the activities sponsored and supervised by the policyholder; while traveling with a group in connection with such activities; or, while traveling directly between school and home. Refer to Additional Information section if coverages contemplated for children age 7 or older. |
| 11 | Project Head Start. Adult supervisors may be insured, but if so, all must be included. | All registered students (and adult supervisors) of the Head Start program sponsored by the policyholder. | While at school or on school grounds; while participating in a program activity; while traveling directly to and from home and school or program activities - provided the participant is directly supervised by an adult supervisor and that travel is in a vehicle designated by the program director and driven by an appointed licensed driver. |
| 12 | Athletic Officials. (Baseball, Basketball, Football, Hockey, Lacrosse, Soccer, Softball, Wrestling and Track) | All members of the policyholder. | While officiating on the premises to which the insured person is assigned by the policyholder; while attending a meeting of the policyholder or while traveling to and from such meeting or premises and home. |
| 13 | Senior Citizen (See Additional Information section) | All members of the policyholder. | While participating in activities sponsored and supervised by the policyholder; or while traveling with a group in connection with such activities. |
| 14 | Institutions of Higher Learning. (Community Colleges, Business Schools and other Specialty Schools); see Additional Information section | All registered full-time non-dormitory students of the policyholder. Registered part-time students and/or instructors may be insured at the option of the policyholder, but if so, all must be insured. | While participating in school activities sponsored by the policyholder on the premises designated by and under the supervision of the policyholder or while traveling with a group in connection with such activities. |
| 15 | Ski groups and other employee, religious, educational and recreational groups taking ski trips. | All participants on the ski trip (including supervisors). | While participating in non-competitive downhill or cross-country ski trip activities sponsored by and under the direct supervision of the policyholder; or while traveling with the group in connection with such activities under the direct supervision of the policyholder on the premises designated by the policyholder. |
Plans and Rates - Groups 1-15
The following plans and rates apply only to the organizations specifically listed in groups 1-15 and are not to be extended to cover other “similar” groups. The benefit plans are available for groups 1-15 as indicated in the Rate Section. “N/A” means Not Applicable.
| Plans | Plan 1 | Plan 2 | Plan 3 | Plan 4 | Plan 5 | Plan 6 | Plan 7 | Plan 8 | Plan 9 | Plan 10 | Plan 11 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Death and Dismemberment Benefits for Loss of: Life |
$1,000 | $1,000 | $1,000 | $2,000 | $3,000 | $5,000 | $5,000 | $1,000 | $5,000 | $2,000 | $2,000 |
| Both hands or both feet or sight of both eyes (or) One hand and one foot (or) Either hand or foot and sight of one eye |
$1,000 | $1,000 | $2,500 | $5,000 | $7,500 | $10,000 | $10,000 | $2,500 | $5,000 | $2,000 | $2,000 |
| Either hand or foot
(or) Sight of one eye |
$500 | $500 | $1,250 | $2,500 | $3,750 | $5,000 | $5,000 | $1,250 | $2,500 | $1,000 | $1,000 |
| Thumb and index finger of either hand | $250 | $250 | $625 | $1,250 | $1,875 | $2,500 | $2,500 | $625 | $1,250 | $500 | $500 |
| Medical Benefits up to: | $1,000 | $1,000 | $1,000 | $3,000 | $5,000 | $25,000 | $25,000 | $1,000 | $5,000 | $500 | $1,000 |
| Deductible Amount | $0 | $25 | $0 | $0 | $0 | $0 | $100 | $0 | $0 | $25 | $25 |
| Dental Expense Limit | $250 | $250 | $250 | $250 | $250 | $1,000 | $1,000 | $250 | $250 | $250 | $250 |
| Accident Total Disability | |||||||||||
| Weekly Benefit | N/A | N/A | N/A | N/A | N/A | N/A | N/A | $50 | $50 | N/A | N/A |
| Maximum Payment Period |
N/A | N/A | N/A | N/A | N/A | N/A | N/A | One Year | Two Years | N/A | N/A |
| Waiting Period | N/A | N/A | N/A | N/A | N/A | N/A | N/A | None | None | N/A | N/A |
| Speech | N/A | N/A | N/A | N/A | N/A | $5,000 | $5,000 | N/A | N/A | N/A | N/A |
| Hearing | N/A | N/A | N/A | N/A | N/A | $2,500 | $2,500 | N/A | N/A | N/A | N/A |
| Catastrophe Benefit | N/A | N/A | N/A | N/A | N/A | $35,000 | $35,000 | N/A | N/A | N/A | N/A |
Rates - Groups 1-15
| Per Person Rates | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Group | Term of Coverage | Minimum Policy Premium | Plan 1 | Plan 2 | Plan 3 | Plan 4 | Plan 5 | Plan 6 | Plan 7 | Plan 8 | Plan 9 | Plan 10 | Plan 11 | |
| 1 | 1 Year | $310 | N/A | N/A | $1.20 | $1.50 | $1.75 | N/A | N/A | N/A | N/A | N/A | N/A | |
| 2 | 1 Year | $310 | N/A | N/A | 1.90 | 2.35 | 2.55 | N/A | N/A | N/A | N/A | N/A | N/A | |
| 3 | 1 Year | $310 | N/A | N/A | 3.05 | 3.75 | 4.25 | N/A | N/A | N/A | N/A | N/A | N/A | |
| 4 | 1 Year | $310 | N/A | N/A | 2.50 | 3.05 | 3.35 | N/A | N/A | N/A | N/A | N/A | N/A | |
| 5 | 1 Year | $310 | General Hospitals | N/A | N/A | 1.75 | 2.20 | 2.45 | N/A | N/A | N/A | N/A | N/A | N/A |
| Mental Hospitals | N/A | N/A | 2.50 | 3.05 | 3.40 | N/A | N/A | N/A | N/A | N/A | N/A | |||
| 6 | 1 Year | $310 | N/A | N/A | 4.35 | 5.30 | 5.80 | N/A | N/A | N/A | N/A | N/A | N/A | |
| 7* | 1 Week | $310 | N/A | N/A | .25 | .30 | .35 | N/A | N/A | N/A | N/A | N/A | N/A | |
| 8* | 1 Day | $310 | N/A | N/A | .90 | 1.15 | 1.30 | N/A | N/A | N/A | N/A | N/A | N/A | |
| 9* | 1 Day | $310 | N/A | N/A | .13 | .16 | .18 | N/A | N/A | N/A | N/A | N/A | N/A | |
| Primary | ||||||||||||||
| 10 & 11 | 3 months | $310 | N/A | N/A | N/A | N/A | N/A | $2.40 | $1.50 | N/A | N/A | N/A | N/A | |
| 9 months | N/A | N/A | N/A | N/A | N/A | 4.60 | 2.80 | N/A | N/A | N/A | N/A | |||
| 1 year | N/A | N/A | N/A | N/A | N/A | 6.30 | 3.80 | N/A | N/A | N/A | N/A | |||
| Excess | ||||||||||||||
| 10 | 3 months | $310 | N/A | N/A | N/A | N/A | N/A | 1.75 | 1.10 | N/A | N/A | N/A | N/A | |
| 9 months | N/A | N/A | N/A | N/A | N/A | 3.30 | 2.05 | N/A | N/A | N/A | N/A | |||
| 1 year | N/A | N/A | N/A | N/A | N/A | 4.55 | 2.80 | N/A | N/A | N/A | N/A* | |||
| 12 | 1 year | $310 |
Wrestling Track |
N/A | N/A | $2.55 | $3.15 | $3.55 | N/A | N/A | $4.55 | $6.25 | N/A | N/A |
|
Basketball Soccer |
N/A | N/A | 2.70 | 3.85 | 4.30 | N/A | N/A | 5.60 | 7.50 | N/A | N/A | |||
|
Baseball Football Softball |
N/A | N/A | 3.75 | 4.60 | 5.10 | N/A | N/A | 6.25 | 8.30 | N/A | N/A | |||
|
Hockey Lacrosse |
N/A | N/A | 5.05 | 6.15 | 6.75 | N/A | N/A | 8.05 | 10.60 | N/A | N/A | |||
| 13 | 1 Year | $310 | N/A | $3.70 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
| 14** | 4 1/2 months | $310 | $1.90 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
| 9 months | 3.80 | |||||||||||||
| Each Summer Session | .75 | |||||||||||||
| 15* | 1 Day or Fractional Part Thereof |
$310 | Downhill Skiing | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | $1.40 | $1.65 |
| Cross Country Skiing | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | .90 | 1.15 | |||
*The maximum period for which a policy will be issued
is as follows: Group #7, 8 weeks; Group #8, 2 weeks; Group #9,
30 days; Group #15, 1 year.
Excess Coverage is not available to Group #11 (Project Head Start).
**These rates apply to full-time students and instructors. If
coverage is desired for part-time students, the rate is $1.00
per person for each semester (up to 4-1/2 months).
Eligible Groups and Scope of Coverage - Group 16
| Group No. | Eligible Groups | Who is Covered | When They Are Covered |
|---|---|---|---|
| 16 | Sports Camps for all types of sports; age 18 and under (age 16-18 Football Camps are not eligible). | All persons registered as Campers must be insured. Counselors, janitors, cooks and similar employees may also be insured at your option. This insurance will not cover children of camp employees or children of counselors, spouses of employees, or volunteers working on special events unless they are registered as campers or employed by the camp. Contact your reporting office for details. | Coverage is provided while in regular attendance on camp premises and while taking part in regularly scheduled, approved camp activities. |
Plans and Rates - Group 16
The following plans apply only to the organizations specifically listed in group 16 and are not to be extended to cover other “similar” groups.
Plans - Group 16
| Plan A | Plan B | Plan C | |
|---|---|---|---|
| Death and Dismemberment Benefits for Loss of: Life | $2,500 | $5,000 | $10,000 |
|
Both hands or both feet or sight of both eyes (or) One hand and one foot (or) Either hand or foot and sight of one eye |
$2,500 | $5,000 | $10,000 |
|
Either hand or foot(or) Sight of one eye |
$1,250 | $2,500 | $5,000 |
| Thumb and index finger of either hand | $625 | $1,250 | $2,500 |
| Medical Benefits up to | $2500 | $5,000 | $10,000 |
| Deductible Amount | $0, $25; or $250 | $0, $25; or $250 | $0, $25; or $250 |
| Dental Expense Limit | $250 | $250 | $250 |
Rates - Group 16 Minimum Policy Premium $310
Cost per Person per week (or fractional part thereof), based on age:
| Plan A - All sports except Soccer and Football* | Plan B - All sports except Soccer and Football* | Plan C- All sports except Soccer and Football* | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Under | 13-15 | 16-18 | Under 13 | 13-15 | 16-18 | Under 13 | 13-15 | 16-18 | |
| Overnight Camps: Full Medical Expense Coverage: | |||||||||
| No Deductible | $2.20 | $4.55 | $7.15 | $2.35 | $4.85 | $7.65 | $2.55 | $5.20 | $8.20 |
| $25 Deductible | 1.60 | 3.35 | 5.25 | 1.80 | 3.60 | 5.70 | 1.95 | 3.95 | 6.20 |
| $250 Deductible | 0.65 | 1.30 | 2.05 | 0.80 | 1.55 | 2.45 | 0.95 | 1.80 | 2.80 |
| Excess Medical Expense Coverage: | |||||||||
| No Deductible | 1.55 | 3.20 | 5.00 | 1.65 | 3.40 | 5.35 | 1.85 | 3.65 | 5.75 |
| $25 Deductible | 1.15 | 2.35 | 3.70 | 1.25 | 2.55 | 4.00 | 1.40 | 2.80 | 4.35 |
| $250 Deductible | 0.45 | 0.95 | 1.45 | 0.55 | 1.10 | 1.70 | 0.70 | 1.30 | 2.00 |
| Day Camps: Full Medical Expense Coverage: | |||||||||
| No Deductible | 2.00 | 4.30 | 6.95 | 2.15 | 4.60 | 7.40 | 2.30 | 4.95 | 7.90 |
| $25 Deductible | 1.45 | 3.15 | 5.10 | 1.60 | 3.45 | 5.50 | 1.75 | 3.75 | 6.00 |
| $250 Deductible | 0.60 | 1.25 | 2.00 | 0.70 | 1.50 | 2.35 | 0.85 | 1.70 | 2.70 |
| Excess Medical Expense Coverage: | |||||||||
| No Deductible | 1.40 | 3.00 | 4.85 | 1.50 | 3.25 | 5.20 | 1.65 | 3.50 | 5.55 |
| $25 Deductible | 1.05 | 2.20 | 3.55 | 1.15 | 2.40 | 3.90 | 1.25 | 2.65 | 4.20 |
| $250 Deductible | 0.40 | 0.90 | 1.40 | 0.50 | 1.05 | 1.65 | 0.60 | 1.25 | 1.95 |
*Where equipment has been issued.
Rates - Group 16 (continued)
| Plan A - Soccer Only | Plan B - Soccer Only | Plan C - Soccer Only | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Under 13 | 13-15 | 16-18 | Under 13 | 13-15 | 16-18 | Under 13 | 13-15 | 16-18 | |
| Overnight Camps: Full Medical Expense Coverage: | |||||||||
| $25 Deductible | $1.60 | $6.80 | $13.25 | $1.80 | $7.35 | $14.35 | $1.95 | $7.95 | $15.45 |
| $250 Deductible | 0.65 | 2.65 | 5.20 | 0.80 | 3.15 | 6.05 | 0.95 | 3.60 | 6.95 |
| Excess Medical Expense Coverage: | |||||||||
| $25 Deductible | 1.15 | 4.75 | 9.25 | 1.25 | 5.15 | 10.05 | 1.40 | 5.60 | 10.85 |
| $250 Deductible | 0.45 | 1.90 | 3.65 | 0.55 | 2.20 | 4.25 | 0.70 | 2.55 | 4.90 |
| Day Camps: Full Medical Expense Coverage: | |||||||||
| $25 Deductible | 1.45 | 6.65 | 13.05 | 1.60 | 7.20 | 14.15 | 1.75 | 7.80 | 15.25 |
| $250 Deductible | 0.60 | 2.60 | 5.10 | 0.70 | 3.05 | 6.00 | 0.85 | 3.50 | 6.85 |
| Excess Medical Expense Coverage: | |||||||||
| $25 Deductible | 1.05 | 4.65 | 9.15 | 1.15 | 5.05 | 9.90 | 1.25 | 5.50 | 10.70 |
| $250 Deductible | 0.40 | 1.85 | 3.60 | 0.50 | 2.15 | 4.20 | 0.60 | 2.50 | 4.85 |
Rates - Group 16 (continued)
| Plan A -Football* Only | Plan B - Football* Only | Plan C - Football* Only | ||||
|---|---|---|---|---|---|---|
| Under 13 | 13-15** | Under 13 | 13-15** | Under 13 | 13-15** | |
| Overnight Camps:Full Medical Expense Coverage: | ||||||
| $50 Deductible | $1.35 | $11.10 | $1.45 | $12.00 | $1.60 | $13.00 |
| $250 Deductible | 0.65 | 5.30 | 0.80 | 6.20 | 0.95 | 7.10 |
| Excess Medical Expense Coverage: | ||||||
| $50 Deductible | 0.95 | 7.75 | 1.05 | 8.40 | 1.15 | 9.15 |
| $250 Deductible | 0.45 | 3.75 | 0.55 | 4.35 | 0.70 | 5.00 |
| Day Camps: Full Medical Expense Coverage: | ||||||
| $50 Deductible | 1.20 | 10.95 | 1.30 | 11.85 | 1.45 | 12.85 |
| $250 Deductible | .60 | 5.25 | 0.70 | 6.15 | 0.85 | 7.05 |
| Excess Medical Expense Coverage: | ||||||
| $50 Deductible | 0.85 | 7.70 | 0.95 | 8.30 | 1.05 | 9.05 |
| $250 Deductible | 0.40 | 3.70 | 0.50 | 4.30 | 0.60 | 4.95 |
*Where equipment has been issued.
**The 16-18 Age Category is not available for Football Camps.
To determine the policy premium for an organization, multiply the per person rate for the selected plan by the number of persons to be insured. For Groups 7, 8, 9, 15 and 16 multiply the per person rate times the number of days or weeks to be covered and then multiply the result by the number of persons to be insured. Compare the resulting total to the minimum policy premium of the group. No policy will be issued for less than the applicable minimum policy premium.
Note: “N/A.” means the plan is not applicable.
Additional Information Pertaining to Program Supplement
It is not the purpose of the Special Risk Accident Program to cover heavily concentrated air travel exposure. However, the rates shown in this section do include air travel as long as the aggregate limit of the group does not exceed $250,000 on any one aircraft. To determine the aggregate limit for the group, multiply the selected death benefit by the number of group members traveling together on a single aircraft. If the aggregate limit is over $250,000, contact your reporting office.
The Special Risk Accident Program Supplement outlined in this section is not available to any group organized for the practice or play of competition team sports.
The Adult Church Group category under Group No. 1 does not include groups engaged in volunteer construction activities.
The program for day care centers, nursery schools, kindergartens and Project Head Start (Groups 10 and 11) is designed to cover normal preschool activities. This program can provide coverage for children age 7 and older for after school Day Care Center activities only, provided the number of children age 7 and over does not constitute a substantial portion of the total number of children to be covered. It is not the intent of this program to provide coverage for this age group while they are participating either in normal school time activities in public or private schools, or in after school “latchkey” activities.
A Catastrophe Benefit has been added to this program (for Groups 10 & 11 only). This benefit pays up to a Maximum of $35,000 if a person is in a Coma or suffers some level of paralysis. Please contact your Reporting office for details.
Programs are also available for pre-schools either specializing in the care of handicapped children or where children age 7 and over make up a substantial portion of the total enrollment.
The Senior Citizen category (Group 13) is written only on an excess basis over and above other group blanket or franchise health insurance coverage; other group hospital or medical service plans and pre-payment coverage; any coverage under labor-management trustee plans, union welfare plans, employer organization plans, or employee benefit organization plans; coverage under any governmental programs, coverage required or provided by any statute and automobile reparations insurance (no-fault) coverage. In addition, a mandatory minimum deductible of at least $25 is required.
The program for Institutions of Higher Learning (Group 14) is not available to trade schools or other schools with activities of a hazardous nature. This program is primarily designed for use in community colleges, business schools, computer science and other specialty type schools. Higher benefits are available upon request through your reporting office.
Coverage for ski exposure is available only to Group 15. This program is not available to any group organized only for the purpose of engaging in competitive skiing. If the group does both recreational and competitive skiing, only recreational skiing will be covered. The Hartford can provide coverage for competitive skiing events under a Sports Accident Program. It is not the intent of the Ski Trip Accident Program to provide coverage for ski jumping. If your group is planning more than one ski trip throughout the year, all of these trips may be insured under one policy. Be certain to indicate whether the skiing is downhill or cross-country; if both, please so indicate when computing the policy premium.
The rates stated in this section contemplate coverage for various groups and their general organizational activities in accordance with the Company’s current Special Risk Accident underwriting practices. The rates indicated are for average size groups. The Home Office may consider lower rates for larger groups, upon request through your reporting office.