Accident Insurance

Accident Insurance  

Overview

Your major medical insurance will help with many of your expenses, but wouldn’t you feel better knowing you’ll have extra help paying some of your bill?

 

Features of this insurance include:

  • Pays you benefits for specific injuries and events resulting from a covered accident, on or after your coverage effective date. The amount paid depends on the type of injury and care received. See the product brochure, certificate of coverage and any applicable riders for a list of covered accidents, along with complete provisions, exclusions and limitations.
  • Rates are typically lower when you purchase group insurance coverage through your employer. Premiums are paid through convenient payroll deductions.
  • Flexibility means you can use the benefit money for any purpose you like.
  • Coverage is available for your spouse under age 70 and children up to age 26 if family coverage is provided or elected. Age requirements may vary by state.
  • Provided by a leading accident insurance provider: Voya Employee Benefits
  • Guaranteed acceptance with no medical exam no matter when you enroll.
  • This is designed to complement your comprehensive medical plan insurance. It is not a replacement for medical insurance.
  • Accident Insurance is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act.  

 

Tell Me More

The cost of Accident Insurance varies. It is very likely that your monthly premium will be less than a trip to the movie theater. See below for your affordable rate.

 

Bi-Weekly Rates (26 Pay Periods)

Employee

Employee and Spouse

Employee and Children

Family

$6.55 $11.30 $12.95 $17.70

 

Enrollment

Add accident insurance coverage to help offset costs that may not be covered under your employer's existing medical plan.


2020 Annual Enrollment
ENROLL NOW

Contact Us

 Address
Mercer Consumer
12421 Meredith Drive
Urbandale, IA 50398
 Phone
1-855-290-5661
 Hours
 M-F 9a-6p ET
 Email
customer.service@mercer.com

How It Works

FAQs

Answers about the plan, including eligibility, options, enrollment, customer service and more.

  • Can I meet with someone one-on-one to get a better understanding of this insurance product?

    Yes, Baystate Health has partnered with the Farmington company during benefits open enrollment. Specially trained Licensed Agents are available onsite at Baystate throughout the open enrollment period, to assist with questions and help you make informed decisions.
  • Who is the provider?

    Accident Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Voya Employee Benefits is a division of ReliaStar Life Insurance Company.
  • How can this help me?

    Most families don’t budget for the costs associated with accidents. When an accident does occur, the last thing on your mind is the charges accumulating while at the emergency room:

    • Ambulance 
    • Emergency room treatment
    • Follow-up doctor visit
    • Medical equipment

     

    These costs can add up fast. Most families have medical insurance that will cover a majority of the expenses. But, what about the out-of-pocket medical expenses, such as lost wages an employee or spouse/domestic partner loses when out of work or staying home to care for an injured family member? You hope that an accident never happens, but at some point you very well may take a trip to your local emergency room. If that time comes, wouldn’t it be nice to have insurance coverage that pays you a benefit regardless of any other insurance you have? Accident insurance does just that, providing benefits to cover the costs associated with unexpected covered accidents.

  • Who is eligible?

    All Baystate and Baycare employees who work at least 16 hours/wk or BVNAH employees who work at least 15 hours/week.
  • Who can enroll?

    You, your spouse and eligible children qualify for this coverage.

    • All active employees (a minimum hours working per week requirement may be required)
    • Your spouse*— under age 70. Coverage is available only if employee coverage is elected.
    • Your children— to age 26. Coverage is available only if employee coverage is elected.

     

    *The use of “spouse” means a person insured as a spouse as described in the certificate of insurance or rider.

  • When can I enroll?

    You can enroll in this benefit during Baystate’s benefits open enrollment each Oct-Nov timeframe. If you are a new hire or have a “qualifying change in life status”, you can enroll within 15 days of your hire date.
  • When is my coverage effective?

    The effective date of coverage is the date you are eligible to begin filing claims. The injury must occur on or after the coverage effective date.

     

    OPEN ENROLLMENT

    • Your coverage becomes effective on January 1 following the election of coverage. Coverage for your spouse and/or children becomes effective on the same date as your coverage.

     

    New Hires

    • Coverage becomes effective at 12:01 AM on the latest of the following:
      • First of the following month after you complete your enrollment.
      • The first day of the month following the date you return to active employment, if you are not in active employment when your coverage would otherwise become effective.
    • Coverage for your spouse and/or children becomes effective on the same date as your coverage.
  • When/how can I cancel my coverage and when would it take effect?

    You can cancel your coverage at any time by contacting Mercer at 855-290-5661 or selecting the Current Benefit Elections option at www.BHBenefitsplus.com, logging in, and declining the benefit(s) you wish to cancel (leave others unchanged). The cancellation would become effective the first day of the month after the request and you would not be able to re-enroll until a subsequent annual enrollment. Your first or second paycheck after the cancellation is processed would reflect the change and a refund should be issued by Voya within 30 days of the date the cancellation is processed, if applicable.
  • What if my employment status changes?

    When you leave or retire from your current employer, you can continue your coverage without interruption, subject to applicable law and the policies' terms and conditions. Although payroll deduction will no longer be available if you retire or leave your company, you will be billed directly by the insurance carrier.
  • How do I pay for this benefit?

    Payments are made via Baystate Health payroll deduction.
  • Will my rates increase as I get older or if I file a claim?

    No, your rates will not increase due to age, health or individual claims.
  • Will I have to take a medical exam to get this coverage?

    No! Your Accident insurance is guaranteed issue, which means no medical questions or tests are required to enroll in this coverage.
  • What types of accidents and injuries am I covered for?

    Once you’re enrolled in this coverage, you may qualify to receive benefits for items such as those listed below, as long as they are a result of a covered accident. Benefit types and amounts are determined by the type of plan selected, the circumstances of your accident and the care you receive. You may be required to seek care for your injury within a set amount of time. Note that there are some variations by state. For a complete description of your available benefits, exclusions and limitations, see your certificate of insurance and any riders.

      

    • Surgery
    • Blood, plasma, platelets
    • Hospital admission
    • Rehabilitation facility*
    • Critical care unit confinement*
    • Hospital confinement
    • Coma
    • Transportation and lodging
    • Family care*
    • Medical equipment
    • Physical or occupational therapy*
    • Speech therapy*
    • Major diagnostic exam*
    • X-ray*
    • Outpatient surgery*
    • Prosthetic device
    • Ground or air transportation*
    • Emergency room treatment*
    • Urgent care facility treatment*
    • Initial doctor visit*
    • Follow-up doctor visit*
    • Chiropractic treatment*
    • Burns or skin grafts
    • Emergency dental work
    • Eye injury
    • Torn knee cartilage
    • Lacerations/sutures
    • Ruptured disk surgical repair
    • Tendon, ligament or rotator cuff surgical repair
    • Concussion
    • Paralysis
    • Hip joint, knee, ankle, foot bone(s) or toe dislocation
    • Shoulder, elbow, wrist, hand bone(s) or finger dislocation
    • Lower jaw dislocation
    • Collarbone dislocation or fracture
    • Partial dislocations
    • Hip, leg, kneecap, ankle, foot or toe fracture
    • Bone of face or jaw fracture
    • Shoulder blade, arm or finger fracture
    • Vertebral fracture
    • Pelvis fracture
    • Rib fracture
    • Skull fracture
    • Sternum fracture
    • Chip fractures

     

  • Exclusions and Limitations

    Exclusions for the Certificate, Spouse Accident Insurance, and Children’s Accident Insurance are listed below. (These may vary by state.) Benefits are not payable for any loss caused in whole or directly by any of the following*:

     

    • Participation or attempt to participate in a felony or illegal activity.
    • An accident while the covered person is operating a motorized vehicle while intoxicated. Intoxication means the covered person’s blood alcohol content meets or exceeds the legal presumption of intoxication under the laws of the state where the accident occurred.
    • Suicide, attempted suicide or any intentionally self-inflicted injury, while sane or insane.
    • War or any act of war, whether declared or undeclared, other than acts of terrorism.
    • Loss sustained while on active duty as a member of the armed forces of any nation. We will refund, upon written notice of such service, any premium which has been accepted for any period not covered as a result of this exclusion.
    • Alcoholism, drug abuse, or misuse of alcohol or taking of drugs, other than under the direction of a doctor.
    • Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.
    • Operating, or training to operate, or service as a crew member of, or jumping, parachuting or falling from, any aircraft or hot air balloon, including those which are not motor-driven. Flying as a fare-paying passenger is not excluded.
    • Engaging in hang-gliding, bungee jumping, parachuting, sail gliding, parasailing, parakiting, kite surfing or any similar activities.
    • Practicing for, or participating in, any semiprofessional or professional competitive athletic contests for which any type of compensation or remuneration is received.
    • Any sickness or declining process caused by a sickness.
    • Work for pay, profit or gain, if your employer elects to exclude work-related sicknesses or accidents under the policy.

     


    *Exclusions and limitations may vary by state. Consult your certificate of insurance for exact language.

     

  • Are there any pre-existing condition limitations with this plan?

    The Voya Accident, Critical Illness, and Hospital Indemnity Plans do not have a pre-existing condition limitation. This will be true for all future Baystate Health Benefits Open Enrollments barring any benefit changes from the initial plan offering.
  • What is the Wellness Benefit, and how do I claim my $100?

    The Wellness Benefit is a rider that is automatically included with your Accident, Critical Illness, and/or Hospital Confinement Indemnity Insurance coverage. It provides an annual benefit payment if you complete a health screening test, whether there is any out-of-pocket cost to you or not. You are eligible to receive one annual benefit of $100, regardless of how many screening tests you may complete. If enrolled, your spouse is eligible to receive the $100 wellness benefit and your children are eligible to receive $50 each, up to a maximum of $200 for all children in a calendar year, if they complete a screening. If you participate in Baystate’s health screenings for employees through the Baystate Healthy program, this screening qualifies for the $100 benefit.

     

    Click here to view more details about what types of screenings qualify on the wellness benefit and here for how to claim it. Personal information provided on a claim form and supporting documentation confirming the name of the person/organization you saw and date of the screening is, generally, what Voya requires. Information regarding other insurance is not needed for this type of claim.

  • I have Voya coverage under more than one plan (Accident, Critical Illness, and/or Hospital Indemnity) that includes a $100.00 wellness benefit. Am I eligible to be reimbursed for that benefit under more than one plan for the same service?

    As long as your coverage under each plan was active on the date of service you are eligible to receive the benefit under each plan.
  • How do I access a claim form and how do file a claim for benefits?

    1. Visit the Voya.com/claims and click on "Get Started".
    2. Complete the questionnaire.
      This generates a custom claim form package for you.
    3. Download your claim form package.
    4. Complete the form package.
      Have each form completed by the appropriate party, as outlined in the claim form package.
    5. Gather additional documents.
      Collect any additional supporting documents, as instructed on the claim form "for you".
    6. Submit.
      Using your preferred submission method, submit your completed and signed forms, as well as any supporting documents.
      • To submit online via a secure upload, visit Voya.com/claims and click on "Upload Documents".
      • To mail or fax your submission, see the top of your custom claims form package.

This is a summary of benefits only. Please review your enrollment materials and any other applicable brochures prior to enrolling in coverage. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of insurance and riders. All coverage is subject to the terms and conditions of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern. To keep coverage in force, premiums are payable up to the date of coverage termination. Accident Insurance is underwritten by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Policy Form #RL-ACC3-POL-16. Form numbers, provisions and availability may vary by state.

 

Forms

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

 

Accident Benefits Guide
Accident Insurance Plan Certificate of Insurance
Accident Insurance Plan State Mandated Forms
Mercer's Role & Compensation

Details of Mercer disclosure of the compensation.