State Specific Information

Group Accident Expense

As approved, some state insurance departments may require modifications to policy application, contract language, benefits, rates and other features. Please refer to the individual contracts specific to each state as the ultimate authority.

This applies to policy/certificate Form Nos. G H1708/G H1708C. This information is for agent use only. It is not for use with consumers.

The following chart represents some of those key differences from the standard contract language, benefits, rates and features:

State Specific Information for Group Accident Expense
Arizona	• Hospital Sickness Rider has state-specific rates (included in proposals).
Arkansas	• Hospital Sickness Rider has state-specific rates (included in proposals).
California	• Hospital Sickness Rider has state-specific rates (included in proposals). • Accident-Only Disability Income Rider is not available. • Outpatient Care Rider is not available. • The Hospital Sickness Rider’s pre-existing condition limitation applies to conditions six months prior to the issue date and for six months after the issue date.
Colorado	• Policy and riders have state-specific rates (included in proposals).
Connecticut	• Policy’s Preventive Care benefit (wellness) is not available. • Hospital Sickness Rider is not available. • Outpatient Care Rider is not available. • Policy has a Home Health Care benefit. • Policy’s Poisoning benefit is included in all plans, including the Prime plan. • There is no waiting period for the policy’s Coma benefit. • There is no waiting period for the policy’s Paralysis benefit.
Idaho	• Policy’s Preventive Care benefit (wellness) is not available. • Policy benefits for treatment in an Intensive Care Unit, Sub-Acute Intensive Care Unit, Rehabilitation Unit and Child Care are payable for a maximum of 31 days. • Hospital Sickness Rider is not available. • Outpatient Sickness Rider is not available.
Indiana	• Policy and riders have state-specific rates (included in proposals). • Eligible dependent children need only be younger than age 26; they do not need to be unmarried or financially dependent on the employee. • Treatment for the Emergency Room, Burns, Concussion, Laceration and Poisoning benefits must be within 180 days of the covered accident.
Kansas	• Policy and riders have state-specific rates (included in proposals). • Outpatient Care Rider is not available. • Definition of physician includes chiropractors. • Policy’s Chiropractor benefit is not available; however, other benefits, requiring diagnosis by or treatment from a physician/chiropractor will be paid. • Policy’s Preventive Care benefit does not provide immunizations. • Hospital Sickness Rider pays limited Mental or Nervous Disorder and Substance Abuse benefits.
Maryland	• Policy and riders have state-specific rates (included in proposals). • Accident-Only Disability Income Rider is not available.
Minnesota	• Policy and riders have state-specific rates (included in proposals). • Policy’s Preventive Care benefit (wellness) is not available. • Outpatient Care Rider is not available.
Mississippi	• Hospital Sickness Rider has state-specific rates (included in proposals).
Missouri	• Preventive Care benefit is available as a rider, but not included in the policy. • Outpatient Care Rider is not available. • Hospital Sickness Rider pays $40 for services for a covered sickness during the 30-day waiting period.
Montana	• Policy and Hospital Sickness Rider have state-specific rates (included in proposals). • Policy’s Chiropractor and Acupuncture benefit is not available; however, other benefits, requiring diagnosis by or treatment from a physician/chiropractor will be paid. • Policy’s Physical, Occupational or Speech Therapy benefit is limited to four visits per accident.
New Jersey	• Hospital Sickness Rider is not available. • Outpatient Care Rider is not available.
New Mexico	• Policy has state-specific rates (included in proposals). • The Hospital Sickness Rider’s pre-existing condition limitation applies to conditions six months prior to the issue date and for six months after the issue date.
North Carolina	• Hospital Sickness Rider is not available.
North Dakota	• Policy’s Preventive Care benefit (wellness) is not available. • Hospital Sickness Rider is not available. • Outpatient Care Rider is not available.
Ohio	• Policy and riders have state-specific rates (included in proposals). • Preventive Care benefit is available as a rider, but not included in the policy.
Pennsylvania	• Hospital Sickness Rider has state-specific rates (included in proposals). • Off-the-job policy and riders are not available. • Hospital Sickness Rider’s pre-existing condition limitation applies to conditions 90 days prior to the issue date.
Rhode Island	• Hospital Sickness Rider has state-specific rates (included in proposals).
South Dakota	• Hospital Sickness Rider has state-specific rates (included in proposals). • Off-the-Job policy and riders are not available.
Tennessee	• Hospital Sickness Rider is not available. • Outpatient Care Rider is not available.
Texas	• Hospital Sickness Rider has state-specific rates (included in proposals). • Preventive Care benefit is available as a rider, but not included in the policy.
Utah	• Policy and Hospital Sickness Rider have state-specific rates (included in proposals). • Definition of physician includes chiropractors. • Policy’s Chiropractor and Acupuncture benefit is not available; however, other benefits, requiring diagnosis by or treatment from a physician/chiropractor will be paid. • Policy’s Coma benefit requires the state has persisted for at least 14 days. • Policy’s Paralysis benefit requires paraplegia or quadriplegia lasting at least 30 days. • The Hospital Sickness Rider’s pre-existing condition limitation applies to conditions six months prior to the issue date and for six months after the issue date.
Vermont	• Hospital Sickness Rider has state-specific rates (included in proposals). • Policy’s Poisoning benefit is not available. • Policy’s Post-Traumatic Stress Disorder benefit is not available. • All policy services must be received within 365 days of the accident.
Virginia	• Policy has state-specific rates (included in proposals). • Policy’s Chiropractor and Acupuncture benefit is not available; however, other benefits, requiring diagnosis by or treatment from a physician/chiropractor will be paid.
Washington	• Policy and riders have state-specific rates (included in proposals). • Policy’s Child Organized Sports benefits is not available. • Policy’s and rider’s benefits must be for services received, death or disability within 365 days of the covered accident. • Hospital Sickness Rider is not available. • Outpatient Care Rider is not available.
West Virginia	• Policy and riders have state-specific rates (included in proposals).
Wyoming	• Hospital Sickness Rider has state-specific rates (included in proposals). • The Hospital Sickness Rider’s pre-existing condition limitation applies to conditions six months prior to the issue date.