Insurance - HL 206 (1)

From: evan gost

Date: 4/25/2014 2:08:57 AM

To: Mark Sztanyo

Subject: Info for PCN

 Mark-

The three attachments address new benefits available under the optional Accidental Death and Dismemberment (A D & D) Insurance.

Ev

AD&D OPTIONAL INSURANCE PURCHASED THROUGH DELTA

INCLUDES ADDITIONAL BENEFITS

Written by Ev Gost

Last year my wife and I were traveling with two other retired Delta couples on a cruise along the Douro River in Portugal. The trip had an unfortunate ending for one of the couples. While walking down a staircase in a museum, one of the pilots fell and sustained a serious injury.

An ambulance transported him to a local hospital where it was determined that, among other things, he had torn the ACL in his right leg. Although the hospital professed to have the capability of performing an operation, he elected to return home to the Los Angeles area for further medical treatment. His substantial expenses included the cost of ambulance service and hospital charges, a 100 mile taxi ride to the closest airport and full airfare for a flight from Porto to Madrid where he was able to connect with a Delta flight.

If the accident had occurred in 2014, he would have been eligible to recover some of those expenditures under the optional Accidental Death and Dismemberment (A D & D) insurance that is purchased through Delta and now administered by Ace American Insurance Company (ACE). That’s right, beginning on January 1, 2014, the optional A D & D insurance provides benefits for accident related emergency medical treatment and emergency medical evacuation. Here are some of the particulars about the coverage as stated in the 2014 A D & D Handbook.

“Medical Emergency Benefit

The Plan will pay up to $10,000 for emergency medical services to treat a covered person if the covered person suffers a medical emergency while traveling and is at least 100 miles from his or her place of permanent residence or outside of his or her country of permanent residence.

Eligible expenses include medically necessary doctor and hospital charges that do not exceed the usual charges for that location, and do not include charges that would be made if there were no insurance. ACE must authorize all expenses in advance, and all services must be rendered by the designated provider.

Emergency Medical Evacuation Benefit

If a covered person suffers a medical emergency while traveling and is at least 100 miles from his or her place of permanent residence or country of permanent residence, the Plan will pay the cost of:

·       Transport to another hospital or treatment facility, or the person’s place of permanent residence, for medically necessary treatment

·       Dispatch of a doctor or specialist if needed to evaluate the need for emergency transport

·       Returning dependent children under 18 to their home, if a covered person who was the only person traveling with the dependent children is confined to a hospital

·       Expenses for an Immediate Family Member or companion who is traveling with the covered person to join the covered person who is being transported to a different treatment facility or the covered person’s place of residence.

Benefits for the covered expenses listed above will not be payable unless the doctor ordering the emergency medical evacuation certifies the severity of the covered person’s emergency condition and the charges incurred are medically necessary and do not exceed the usual charges for that location, and no not include charges that would be made if there were no insurance. Further ACE must authorize all expenses in advance and services must be provided by the designated assistance provider.”

The wording from the Handbook needs some clarification. A “medical emergency” under this insurance plan appears to be limited to conditions resulting from an injury where accidental harm is sustained. You should refer to the Handbook and the Insurance Certificate for details.

As stated previously, if the 2014 additional coverage had been available in 2013, our travel companions on the Duoro River (who were enrolled for A D & D insurance) would have been insured under the policy—with one caveat. They would have been required to obtain advanced authorization for the expenses from ACE.

How does an individual request advanced authorization? The telephone contact number for ACE is (855) 672-1273; however the 24/7 numbers are as follows:

·       within the U. S. (800) 839-2401

·       internationally (480) 379-1914.

For reference, the policy number is ADD N04983233

There are a number of additional benefits under the optional A D & D Insurance including mortgage relief, bereavement counseling, rehabilitation, home alteration and vehicle modification, return of remains, burial and cremation, hospital stays as well as a number of other benefits. Details of the coverage are included in the 2014 A D & D Insurance Handbook and 2014 A D & D Insurance Certificate posted on the Delta Extranet website. To view these documents proceed as follows:

·       Log onto the Delta ExtraNet website at www.dlnet.delta.com with your PPR number and password

·       Place your mouse over Employee Info scroll down and click on Self-service

·       Place your mouse over My Benefits & Life Events scroll down the center column under Learn and click on Health Disability and Insurance

·       On the left side scroll down and click on Resource Materials

·       Click on Documents and Forms

·       In the center column click on the icon after 2014 A D & D Insurance and 2014 A D & D Insurance Certificate.

ACE Insurance has published the attached document entitled Travel Program Benefits.

Disclaimer: The information in this article is not guaranteed to be accurate, but is believed to be accurate as of the date of its writing. For up to date information about the Insurance Plan and its benefits, you should refer to the latest A D & D Insurance Handbook and the Insurance Certificate, both of which should be posted on the Delta Extranet website.

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 ATTENTION

In the event of a medical emergency

call MedAire, Inc. immediately and reference your Membership number 00GCMA087921

24-Hour Access

1-800-839-2401 (Toll free from US and Canada)

+1-480-379-1914 ( From outside the US)

Call when:

 You require a referral to a hospital or doctor

 You are hospitalized

 You need to be medically evacuated or repatriated

 You need to guarantee payment for medical expenses

 You experience local communication problems

When you call MedAire, please be prepared with the following information:

1. Name of caller, phone no., fax no., relationship to

Covered Person;

2. Covered Person’s name, employee ID, age, sex and membership number;

3. A description of the Covered Person’s condition;

4. Name, location, and telephone number of hospital;

5. Name and telephone numbers for the treating doctor; where and when the doctor can be reached;

6. Health insurance information, worker’s compensation, or automobile insurance information if the Covered Person had an accident.

“Covered Person” means the person insured under the applicable ACE policy.

By requesting assistance you agree to assign to us your rights to recover from any of your responsible insurers any expenses we incurred.

ATTENTION

Medical Personnel or Police

In the event of a medical emergency, MedAire will provide the services on the card below. To verify eligibility call the multi-lingual call center 24 hours a day toll free at 1-800-839-2401 if

you’re inside the USA or Canada; or if you’re outside the USA  call + 1-480-379-1914.

 In addition to the insurance protection provided by your Group Accident insurance plan, Delta has arranged with MedAire, Inc. to provide you with access to its travel assistance services around the world. These services include:

 Medical Assistance including referral to a doctor or medical specialist, medical monitoring when you are hospitalized, emergency medical evacuation to an adequate facility, medically necessary repatriation and return of mortal remains.

 Personal Assistance including pre-trip medical referral information and while you are on a trip: emergency medication, embassy and consular information, lost document assistance, emergency message transmission, emergency cash advance, emergency referral to a lawyer, translator or interpreter access, medical benefits verification and medical claims assistance.

 Travel Assistance including emergency travel arrangements, arrangements for the return of your traveling companion or dependents and vehicle return.

This information provides you with a brief outline of the services available to you. Reimbursement for any service provided is limited to the terms and conditions of Delta’s Group Accident insurance plan (AD&D) policy under which you are insured. You will be required to pay for services not covered. A third party vendor may provide services to you. MedAire makes every effort to refer you to appropriate medical and other service providers. It is not responsible for the quality or results of service provided by independent providers.

In all cases, the medical providers, facilities, legal counsel or other professional service providers suggested by MedAire are not employees or agents of MedAire and the choice of provider is yours alone. MedAire assumes no liability for the services provided to you under this arrangement, nor is it liable for any negligence or other wrongful acts or omissions of any of the legal or health care professionals providing services to you. Travel assistance services are not available if your coverage under the policy is not in effect.

For medical referrals, evacuation, repatriation or

other services please call:

In the event of a medical emergency call MedAire, Inc. immediately

and reference your Membership number

00GCMA087921

24-Hour Access

1-800-839-2401 (Toll free from US and Canada)

+1-480-379-1914 ( From outside the US)

Visit www.medaire.com for access to global threat assessments and location based intelligence. Submit request using the contact screen.

TRAVEL ASSISTANCE PROGRAM

Organization: Delta Air Lines

Policy Number: ADD N04983233 (Voluntary Accident) or ADD N04983245 (Private Pilots)

Assistance Provider: MedAire, Inc., An International SOS Company

MedAire, Inc. provides emergency medical and travel services and pre-trip information services. Please call when:

 You require a referral to a hospital or doctor

 You are hospitalized

 You need to be medically evacuated or repatriated

 You need to guarantee payment for medical expenses

 You experience local communication problems

 


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