In the AMA Tradition... Serving the insurance Needs of Physicians and Their Families
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- Rudolf Lynch
- 10 years ago
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1 In the AMA Tradition... Serving the insurance Needs of Physicians and Their Families Almost three decades ago, the American Medical Association (AMA) - recognizing the importance of highquality insurance protection - began to sponsor disability income insurance for its physician members. In 1990, the AMA received requests from residents for disability income coverage. In response, the House of Delegates passed a resolution calling for a study to investigate the feasibility of offering a new AMAsponsored program of insurance plans to better meet the need of residents. Based on a review of the information collected, the AMA determined that there was a significant need for a comprehensive program that included disability income. History of the Underwriter Provident Life and Accident Insurance Company, founded in 1887, is today a subsidiary of UnumProvident Corporation, the world leader in income and lifestyle protection. Provident was one of the first companies to enter the group insurance business, helping to pioneer payroll deduction plans, group medical insurance, and affordable accident and sickness coverage for workers in high-risk occupations. The AMA Insurance Agency, Inc. and Provident Life and Accident Insurance Company have had a longstanding relationship. Since the early 1 970s the Agency and Provident have worked as a team to provide quality insurance protection for physicians and their families. When it came to the development of a group insurance program for students and residents in the medical field, it was imperative to the agency that the partner selected have a strong financial background, the ability to offer quality coverage, and a definite focus on the customer. Provident was the natural underwriting partner for the Agency. AMA Insurance Agency, Inc. and Provident developed the AMA-Sponsored Med Plus Advantage Insurance Program. Provident is rated A+ (Superior) by A.M. best for financial condition and operating performance; this rating by an independent insurance analyst attests to Provident s financial condition and operating performance.
2 DISABILITY INCOME INSURANCE PLAN Eligibility: Plan Features: Plan Features (continued): To be eligible for coverage, students must be engaged full-time in the curriculum at the University of Florida College of Medicine. The coverage is provided with guaranteed insurability and helps to protect a student should he/she become disabled. The plan provides a monthly benefit for a covered student should he become disabled -Total Disability, and Total and Permanent Disability (as these terms are defined in the certificate of insurance) will determine payment of benefits. The monthly benefit may be reduced by any salary or other compensation payments in excess of $3000 from the employer. Premiums are waived during the period of time disability benefits are payable. Benefit payments for total disability due to mental and nervous disorders, as defined in the certificate of insurance, for which treatment is received on an outpatient basis, will be limited to 24 months while the student is insured under the plan. When a covered student is Totally and Permanently Disabled he/she is eligible for the following: A $5,000 lump sum benefit Repayment of all the eligible debt up to $150,000 that a student is legally liable to repay for college and/or medical education. Survivor Benefit If a covered student dies during a total disability that has lasted for at least 6 consecutive months and has an eligible survivor, the plan pays a benefit to the eligible survivor equal to 4 times the amount of the monthly benefit paid immediately prior to death.
3 AMA-Sponsored Med Plus Advantage Disability Plan for Medical Students At the University of Florida College of Medicine Monthly Benefit Medical Students: $1,000 Yrs.1-2 $1,500 Yrs. 3-4 Underwriting Guaranteed Issue - all students will be insured Elimination Period 90 Days After 90 days of disability, you become eligible to receive the monthly disability benefits Definition of Total Disability First 60 months Unable to perform material duties of student After 60 months Unable to perform for pay or profit in a job for which you are qualified by reason of training, education, or experience Benefit Period To age 65 Monthly benefit will not be reduced by other disability benefits. Benefits will be reduced by other work income earned. Recurring Disability 6 months Definition of Permanent & Total Not expected to recover; Unable to work in a Disability position for which you are trained by reason of education, training or experience; Must be totally disabled for at least 12 months. Permanent & Total Disability Benefits $150,000 Loan Payoff $5,000 One time Lump Sum Benefit Continuation after Graduation Guaranteed Issue to $2,000/$2,500 MPA Resident Plan with loan payoff and lump sum benefits. Pre - Existing Condition Limitation Losses beginning after 12 months from the effective date caused by pre-ex conditions are covered.
4 PROPOSED ANNUAL PREMIUM RATES (PER STUDENT) Disability Income Plan for Medical Students: $48.03 $1,000 monthly benefit years 1 & 2 $1,500 monthly benefit years 3 and 4 90 day Elimination Period Benefit Period to age 65 12/12 pre-ex August 1, 2002
5 Preexisting Conditions Limitation: Benefits will not be paid for any condition which, within 12 months prior to the effective date of the student s insurance, resulted in receiving medical advice or treatment. Benefits will not be paid for loss which starts within l2 months of the effective date of the student s insurance and which is caused by pre-existing conditions. What is not covered: The plan will not pay benefits for loss caused by war or any act of war; intentionally selfinflicted injury; periods of disability which occur outside the United States unless the student is temporarily traveling for business or pleasure; any period of disability during which the student is not residing in the United States or Canada, unless the Insurance Company agrees in writing to provide such coverage before the student leaves; or Preexisting conditions except as stated above. Continuation Option Covered students beginning residency training are eligible to continue their coverage, without evidence of insurability, as follows: During the first two years of residency: $2,000 After completion of two years of residency: $2,500 At the completion of residency training, covered residents are eligible to convert to an individual disability income plan of up to $5,000 without medical underwriting.
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