Full benefits breakdown

Your full benefits, all in one place

Below is the full benefits breakdown for the supplemental benefits Combined Insurance, a Chubb company, is bringing to Birmingham FOP Lodge 1.

These benefits are designed to provide additional financial protection when you and your family need it most. Benefits from covered claims are paid directly to you, the insured, according to the terms of each policy. That means the money can be used for medical expenses, household bills, lost income, transportation, childcare, or whatever expenses you need to take care of.

Your coverage can go with you

These benefits include portability provisions. If you leave employment or retire, you may be able to take your coverage with you and continue your protection, subject to the portability provisions and requirements of the applicable policy.

Guaranteed-issue coverage

You have access to guaranteed-issue amounts under these supplemental benefit offerings. This allows you to obtain coverage up to the applicable guaranteed-issue amount without answering health questions.

Cash benefits designed for you

When a covered claim occurs, applicable cash benefits are paid directly to the insured rather than being restricted to paying a particular medical bill. Members can use their benefit money where they need it most.

This website provides a summary of benefits. Coverage is subject to eligibility, policy provisions, exclusions, limitations and applicable state requirements. The issued policy and certificate govern.

01 · ACE Accident

ACE Accident

24-Hour Accident Protection

Accidents don’t always happen on the job. ACE Accident provides 24-hour coverage with benefits designed to help with the financial impact of covered injuries, whether they occur on or off duty.

Gunshot wound

$5,000

Gunshot Wound benefit under Serious Injuries.

PTSD

$50

Post-Traumatic Stress Disorder — per visit, maximum 6 visits.

Sports package

+25%

Benefits are 25% higher when a covered accident results from participating in organized sports, up to $1,000 per person per year.

First accident benefit

$100

On the first covered accident claim.

Built for the badge

Occupational exposure benefits

Occupational Hepatitis B, C or D: $1,000
Occupational HIV: $1,000
Occupational Invasive MRSA Infection: $1,000
Occupational Rabies: $1,000
Occupational Tetanus: $200
Occupational Tuberculosis: $200

Initial care

Emergency Room: $200
Urgent Care: $150
Initial Doctor Visit: $75
Telemedicine Services: $75

Hospital & facility benefits

Standard Hospital Admission: $1,250
ICU Hospital Admission: $2,500
Hospital Confinement: $300 per day, up to 365 days
ICU Confinement: $600 per day, up to 30 days
Outpatient Surgery Facility: $25
Rehabilitation Admission: $1,250
Rehabilitation Confinement: $180 per day, up to 30 days
Recovery Benefit: $75 per day, up to 7 days

Ambulance & medical support

Air Ambulance: $2,000
Ground Ambulance: $300
Appliance: $200
Blood, Plasma or Platelets: $300

Burns

Second-Degree Burns covering at least 36% of the body: $1,000
Third-Degree Burns, 9–34 square inches: $2,000
Third-Degree Burns, 35+ square inches: $12,000
Skin Graft: 25%

Chiropractic care

Chiropractic Care: $50 per visit
Maximum visits per accident: 3
Maximum visits per calendar year: 6

Serious injuries

Coma: $12,500
Dislocations: Up to $4,800
Partial Dislocations: 25%
Ear Injury: $300
Eye Injury: $300
Fractures: Up to $7,000
Gunshot Wound: $5,000
Herniated Disc Surgery: $750
Traumatic Brain Injury: $300
Organ Loss: $1,500

Emergency dental

Crown: $400
Extraction: $100
Dentures: $400
Implants: $400

Joint replacement

Elbow: $750
Hip: $1,500
Knee: $1,000
Shoulder: $900

Knee cartilage

Torn Knee Cartilage: $750
Exploratory arthroscopic surgery with no repair/debridement: $200

Lacerations & puncture wounds

Over 15 cm and repaired by stitches: $1,000
Over 5 cm through 15 cm and repaired by stitches: $500
5 cm or less and repaired by stitches: $200
No stitches, staples or glue required, or puncture wound: $30

Loss of finger, toe, hand, foot, hearing or sight

Loss of hands, feet, sight in both eyes or hearing in both ears: $20,000
Loss of one hand, one foot, sight in one eye or hearing in one ear: $10,000
Loss of two or more fingers/toes or combination: $2,000
Loss of one finger or toe: $1,000

Paralysis

Two limbs: $10,000
Four limbs: $15,000

Prosthetics

One prosthetic device/artificial limb: $1,500
More than one prosthetic device/artificial limb: $3,000

Surgery & repair

Abdominal, Cranial or Thoracic Surgery: $1,500
Hernia Surgery: $200
Repair of more than one tendon, ligament or rotator cuff: $1,250
Repair of one tendon, ligament or rotator cuff: $750
Exploratory arthroscopic surgery without repair: $200

Additional accident benefits

Family Care: $30 per day, per child in a childcare center, up to 30 days
Follow-Up Treatment: $75 per visit, maximum 3 visits
Lodging: $150 per night when 100+ miles away, maximum 30 nights
Major Diagnostic Exam such as CT/MRI: $250
Medical Supplies: $20
Medicine Benefit: $20
Post-Traumatic Stress Disorder: $50 per visit, maximum 6 visits
Residence/Vehicle Modification: $1,000
Physical, Occupational or Speech Therapy: $50 per visit, maximum 10 visits
Transportation: $600 per trip when 100+ miles away, maximum 3 trips
X-Ray: $40

Accident wellness benefit

Annual Wellness Benefit: $50 per covered person per year
Waiting Period: 30 days

The benefit is available when a covered person completes an eligible preventive screening/service according to the policy.

02 · ACE Critical Illness

ACE Critical Illness

Financial Protection When a Serious Diagnosis Changes Everything

ACE Critical Illness provides lump-sum benefits based on the insured’s selected face amount when a covered condition is diagnosed. The plan also includes recurrence benefits and additional support benefits designed to help during treatment and recovery.

No lifetime maximum

Unlimited

Maximum Benefit Amount — Unlimited. The plan allows additional benefits for subsequent qualifying diagnoses rather than imposing one overall lifetime maximum.

Recurrence benefit

100%

Recurrence benefit for qualifying subsequent diagnoses, subject to the policy’s recurrence requirements.

Recurrence qualifying conditions include: Aneurysm – Cerebral or Aortic, Benign Brain Tumor, Cancer, Coma, Coronary Artery Obstruction, Heart Attack, Major Organ Failure, Stroke, Sudden Cardiac Arrest, Transient Ischemic Attack and Carcinoma In Situ.

Covered conditions — % of selected face amount

Alzheimer’s Disease: 100%
Aneurysm: 100%
Benign Brain Tumor: 100%
Breast Cancer Carcinoma In Situ: 100% of Face Amount
Cancer, except skin cancer: 100%
Carcinoma In Situ: 25%
Coma: 100%
Coronary Artery Obstruction: 25%
End Stage Renal Failure: 100%
Heart Attack: 100%
Major Organ Failure: 100%
Multiple Sclerosis: 50%
Paralysis or Dismemberment: 100%
Parkinson’s Disease: 100%
Stroke: 100%
Sudden Cardiac Arrest: 100%
Transient Ischemic Attacks: 10%
Skin Cancer Benefit: $250, payable once per insured per year

Occupational package

100% of face amount

For qualifying occupational conditions including:

HIV
Hepatitis B, C or D
MRSA
Rabies
Tetanus
Tuberculosis

when contracted on the job and all applicable policy requirements are met.

Advocacy package

Best Doctors — Includes physician referrals, an Ask the Expert hotline and an in-depth medical review of diagnosis and treatment plan.

Health Champion Resources — Provides claims navigation, medical travel assistance and financial advice following a critical illness diagnosis.

Diabetes benefits

Diabetes Diagnosis Benefit: $500
Diabetes Service Benefit: $100

Service benefit available once per month, up to 6 times, for qualifying programs such as smoking cessation, nutritional counseling, gym membership or fitness programs.

Additional benefits

Bariatric Surgery Rider: $1,000
Mortgage & Rent Helper: $500 per month, up to 6 months

Mortgage & Rent Helper applies when applicable requirements are met after the insured misses 5 or more days of work.

Critical illness wellness benefit

Wellness Benefit: $50 per covered person per year
Waiting Period: 30 days

Includes qualifying screenings plus immunizations and physicals.

03 · Chubb Disability Income

Chubb Disability Income

Protect Your Paycheck When You Can’t Work

Disability Income is designed to replace a portion of income when a covered sickness or injury prevents an employee from working. There are two available benefit-period options: the 3-Month Diamond Plan and the 6-Month Diamond Plan.

First-day hospital coverage

Day 1

If an employee is hospitalized because of a covered disability, the elimination period is waived.

First-day outpatient surgery coverage

Day 1

If an employee undergoes a qualifying outpatient surgical procedure because of a covered sickness or injury, the elimination period is waived.

Core disability benefits — both plans

Coverage Type: Non-Occupational
Injury Elimination Period: 14 days
Sickness Elimination Period: 14 days
Maximum Benefit: 60% of income, up to $5,000 per month
Minimum Benefit: $300 per month
Partial Disability Benefit: Up to 50% of the Maximum Benefit Amount
Mental or Nervous Disorders: Covered at 50%
Substance Abuse: Covered at 50%
Portability: Yes
Integration with other sources of income: Yes
Pre-Existing Condition Limitation: 12/12
Pre-Existing Conditions Credit for Takeovers: Takeover

Waiver of premium

Premium is waived after the insured has been disabled for 14 or more consecutive days following the elimination period, subject to policy terms.

Organ donation

Disabilities resulting from organ donation are covered as a sickness and the elimination period is waived.

04 · Group Hospital Indemnity

Group Hospital Indemnity

Cash Benefits for Covered Hospital Care

Hospital Indemnity provides cash benefits for covered accidents and sicknesses involving hospital and related care. These benefits can help with expenses that major medical insurance may not cover.

Immediate care benefits

Emergency Room: $150 per day · max 2 days per calendar year
Ground or Water Ambulance: $250 per day · max 2 days per calendar year
Air Ambulance: $1,000 per day · max 2 days per calendar year

Hospitalization benefits

Hospital Admission: $1,500 · max 1 benefit per calendar year
Hospital Confinement: $150 per day
Maximum per confinement: 30 days
Maximum per calendar year: 30 days

Mental & nervous disorder facility benefit

Per day: $200
Maximum per calendar year: 30 days

This benefit applies to qualifying confinement in a hospital or mental-health facility resulting from a mental and/or nervous disorder.

Outpatient care — therapy services following confinement

Per day: $75
Maximum per confinement: 12 days
Maximum per calendar year: 12 days

Additional provisions

Coverage Type: 24-Hour
Pre-Existing Conditions Limitation: 12/12
Childbirth Limitation: None
Interim Coverage: Not Included

05 · Universal Life Protector

Universal Life Protector

Life Insurance You Own and Can Keep

Universal Life Protector provides individually owned life insurance designed to provide financial protection for you and your family while also offering flexibility and cash-value features.

Portability — you own the policy

Unlike typical group benefits tied directly to an employer, this individually issued policy stays with you even if you leave your present job.

Coverage to age 100

As long as sufficient premiums are paid and sufficient policy value is maintained, coverage can continue until age 100, subject to the policy’s terms.

Flexible premiums

Once sufficient cash value has accumulated, premium payments may be reduced or skipped as long as sufficient funds remain to cover the cost of protection.

Accelerated payment benefit

The policy can pay partial or full benefits early if, before age 64, the insured meets the policy requirements for a qualifying terminal condition or qualifying permanent confinement.

Cash value

Guaranteed interest rate: 2.5%, compounded annually
Income earned on cash value is tax deferred under current law
The flyer states the death benefit is free of income taxes under current law
The policy may be assigned as collateral for a loan

Family coverage options

Coverage options are available for the insured, spouse, children and grandchildren.

Children and grandchildren may have standalone coverage options of $10,000 or $20,000.

Universal Life coverage and options are subject to policy terms, limitations and applicable underwriting approval.

Wellness benefits

Your wellness benefits can pay you back every year

Your ACE Accident and ACE Critical Illness coverage aren’t only there when something goes wrong.

Both the ACE Accident and ACE Critical Illness policies include a $50 annual Wellness Benefit for each covered person on the policy when an eligible wellness screening or service is completed and the applicable wellness claim is submitted.

The Wellness Benefit is paid directly to you.

You do not have to experience an accident or be diagnosed with a critical illness to receive the Wellness Benefit. It is a separate benefit designed around eligible preventive care.

So even if your family goes the entire year without an Accident or Critical Illness claim, your family can still receive up to $400 from these two policies by completing eligible wellness screenings/services and submitting the applicable wellness claims.

Example: family of four

ACE Accident

4 covered family members × $50

= $200 /yr

ACE Critical Illness

4 covered family members × $50

= $200 /yr

$400 back per year

A family of four covered under both ACE Accident and ACE Critical Illness can receive up to $400 per year in Wellness Benefits when all four covered family members complete an eligible wellness screening or service under each policy and the applicable claims are approved.

The $50 annual Wellness Benefit described above applies to ACE Accident and ACE Critical Illness. The Birmingham FOP custom Group Hospital Indemnity plan does not include a wellness benefit.

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