A schedule of cash benefits paid to an employee after a covered accident. Not a percentage of a bill — a fixed amount for each thing that happens, from the ambulance ride to the nights in hospital, paid to them rather than to a provider.
Worksite benefits are issued to a business, not to a person. A contract requires a minimum of five enrolled employees, and an eligible employee has to be actively at work — seasonal, temporary and part-time staff are not eligible. If you are shopping for yourself rather than for a workforce, this is the wrong section: our individual supplemental coverage is a different product with different rules, and it is linked at the foot of this page.
This is group accident insurance, offered through an employer. It is not health insurance, it is not a substitute for major medical coverage, and it cannot be bought by an individual — a contract requires a minimum of five enrolled employees.
Most insurance pays a share of what you are charged. This pays a set amount for each covered thing that happened: the ambulance, the emergency room visit, the X-ray, the fracture, each night as an inpatient. Those amounts add up independently of what the medical plan does or does not pay, and the cheque goes to the employee.
Because it is not tied to a bill, there is nothing to submit it against. An employee who has met their deductible already can put it toward the rent, the childcare or the fuel to get to a follow-up appointment. That is the practical reason these get claimed — the non-medical costs of an accident are the ones nothing else covers.
The Value plan carries the core treatment benefits. Classic and Preferred add the schedule benefits that make up most of a serious claim — fractures, dislocations, surgical repairs, accidental death and dismemberment — and Preferred pays more on almost every line. The full comparison is below, transcribed from the carrier's own brochure. Which tier suits a workforce usually comes down to whether the work is physical.
Accident coverage is issued with no health questions and no medical exam, subject to the five-life minimum. That is unusual and it is the reason this is often the first product a small employer adds: nobody is declined for their health history.
Every figure below is transcribed from ManhattanLife Advantage Series Accident Indemnity brochure ASACC-BR 0721. Benefits, riders and amounts vary by state, and the certificate issued to your group governs.
Payable for initial treatment within 60 days of a covered accident, once per accident. Value $200, Classic $150, Preferred $200.
Payable for initial treatment within 30 days of a covered accident, once per accident. Value $200, Classic $150, Preferred $200.
Payable for initial treatment within 60 days of a covered accident, once per accident. Value $150, Classic $75, Preferred $100.
Payable twice per covered accident. Value $100, Classic $50, Preferred $100.
Transport by ground ambulance due to injury from a covered accident, maximum one transport per accident. Value $500, Classic $150, Preferred $300.
Payable for transport to a hospital. Value $1,500, Classic $500, Preferred $1,000.
Payable once per covered accident and once per calendar year. Value $1,000, Classic $750, Preferred $1,500.
Payable for each day confined as an inpatient, up to 365 days per covered accident. Value $250, Classic $150, Preferred $300.
Payable if ICU admission is within 48 hours of hospital admission. Value $1,000, Classic $750, Preferred $1,500.
Payable each day confined to an intensive care unit, up to 30 days per covered accident. Value $500, Classic $300, Preferred $600.
X-ray: Value $150, Classic $100, Preferred $150. Medical imaging (MRI, CT scan) or EEG: Value $100, Classic $75, Preferred $100.
Not payable if the concussion benefit is paid.
Payable once per covered accident. Value $300, Classic $150, Preferred $300.
10 visits per covered accident. Classic $45, Preferred $90. Not carried on the Value plan.
3 visits per covered accident. Classic $45, Preferred $90. Not carried on the Value plan.
Payable to the named beneficiary. Classic $50,000, Preferred $75,000. Not carried on the Value plan.
Spouse benefit is 50% and each child 25% of the employee benefit.
Payable according to a schedule based on the specific loss incurred. Classic $50,000, Preferred $75,000. Not carried on the Value plan.
Spouse benefit is 50% and each child 25% of the employee benefit.
Payable if death results from an accident while the insured is a fare-paying passenger on a commercial airline, passenger train or intercity bus. Classic $100,000, Preferred $150,000. Not carried on the Value plan.
Spouse benefit is 50% and each child 25% of the employee benefit.
Payable if received within 90 days of a covered accident. Classic $50 to $250, Preferred $50 to $500. Not carried on the Value plan.
Payable once per accident for a device or devices needed because of the accident. One device $750, multiple devices $1,500, on both the Classic and Preferred plans. Not carried on the Value plan.
Payable if the insured needs care that is not available locally and more than 50 miles from their residence. Train or plane: Classic $100, Preferred $200. Bus: Classic $50, Preferred $100. Not carried on the Value plan.
Payable for an adult family member when an insured is hospitalised more than 100 miles from home, maximum 30 days. Classic $50 a night, Preferred $100 a night. Not carried on the Value plan.
Payable according to a schedule for second and third degree burns when treatment is received within 72 hours of the covered accident. Classic $100 to $10,000, Preferred $100 to $10,000. Not carried on the Value plan.
Payable according to a schedule when diagnosed and treated by a doctor within 90 days of the covered accident. Classic $70 to $6,000, Preferred $140 to $12,000. Not carried on the Value plan.
Payable according to a schedule when diagnosed and treated by a doctor within 90 days of the covered accident. Classic $10 to $3,600, Preferred $20 to $7,200. Not carried on the Value plan.
Payable when a laceration is repaired with stitches by a doctor within 72 hours of the covered accident, the amount based on its length. Classic $25 to $100, Preferred $50 to $200. A laceration not requiring stitches but treated by a doctor within 72 hours pays the amount shown in the certificate. Not carried on the Value plan.
Payable when treatment is received within 60 days of the covered accident and surgical repair is performed within 90 days. Classic $300 to $600, Preferred $600 to $1,200. Not carried on the Value plan.
Payable when treatment is received within 60 days of the covered accident and surgical repair is performed within 90 days. Classic $300 to $600, Preferred $600 to $1,200. Not carried on the Value plan.
Payable when treatment is received within 60 days of the covered accident and surgical repair is performed within one year. Classic $300 to $600, Preferred $600 to $1,200. Not carried on the Value plan.
Payable when surgical repair is performed within one year. Classic $300 to $600, Preferred $600 to $1,200. Not carried on the Value plan.
Payable when treatment is received within 60 days and surgical repair is performed within one year. Classic $500, Preferred $1,000. Not carried on the Value plan.
Payable when the injury does not require surgical repair. Classic $200, Preferred $400. Not carried on the Value plan.
Classic $1,500, Preferred $3,000. Not carried on the Value plan.
Excludes hernia.
Payable once per covered accident for surgery performed in an ambulatory surgical centre or outpatient hospital facility. Classic $150, Preferred $300. Not carried on the Value plan.
Administered for a covered surgery where a benefit is being paid. Classic $150, Preferred $300. Not carried on the Value plan.
Classic $100, Preferred $200. Not carried on the Value plan.
Payable if the comatose state lasts more than 30 days and diagnosis indicates a permanent neurological deficit. Classic $10,000, Preferred $20,000. Not carried on the Value plan.
Payable when diagnosed within 72 hours of the covered accident using medical imaging. Classic $100, Preferred $200. Not carried on the Value plan.
Payable for injury to sound natural teeth. Crown: Classic $150, Preferred $300. Injury resulting in extraction: Classic $50, Preferred $100. Not carried on the Value plan.
Payable for an eye injury from a covered accident requiring surgical repair performed within 90 days. Surgical repair: Classic $150, Preferred $300. Removal of a foreign body from the eye: Classic $50, Preferred $100. Not carried on the Value plan.
Payable once per covered accident, and must require treatment by a doctor and surgery. Classic $750, Preferred $1,500. Not carried on the Value plan.
Payable once per lifetime. Classic $300, Preferred $600. Not carried on the Value plan.
Paraplegia or quadriplegia, payable if the paralysis lasts more than 90 days and is diagnosed by a doctor within those 90 days. Preferred $12,500 to $25,000. Carried on the Preferred plan only.
Increases the total benefit paid by 10%, to a maximum of $1,000, if the injury to a dependent child occurs during an organised sports event or a scheduled practice. Classic and Preferred plans. Not carried on the Value plan.
Waives premiums after the insured has been disabled for six consecutive months because of a covered accident.
Pays $50 when an insured receives a covered screening, up to one per calendar year per insured.
THIS POLICY PROVIDES LIMITED BENEFITS.
Benefits and riders may vary by state and may not be available in all states. This is not a complete disclosure of plan qualifications and limitations. The amount of benefits provided depend on the plan selected. Premiums will vary according to the selection made.
Benefits are payable only as the result of treatment received for an Injury due to a Covered Accident. Limitations Apply.
Yes. This is not workers' compensation. It pays on covered accidents whether they happen on the job, at home or on holiday, which is why employees who already have workers' comp still find it worth having. Benefits are payable only for treatment received for an injury due to a covered accident, and limitations apply — read the certificate.
No, and it does not replace it. Workers' compensation is a statutory employer obligation that covers work-related injury. This is voluntary coverage an employee buys that pays them cash, and it pays regardless of where the accident happened.
Eligible children can be covered. The death and dismemberment benefits are scaled for dependants rather than paid at the employee amount, and there is an additional benefit when an injury happens during an organised sports event or a scheduled practice. Both are in the table below.
Tell us roughly how many employees you have and what you are trying to add. We will tell you straight away whether the group qualifies, before either of us spends any more time on it.