FIND OUT WHAT UBA OFFERS

UBA MEMBERSHIP PLANS

We're here to help answer any questions at 866-438-4274.
To view UBA Plan details, click on the + in the table below.



Plan details below are for plans purchased on or after 10-01-20. If you purchased a plan prior to 10-01-20, login to your member portal for your plan details. The plan details listed below may be different from the plan you purchased. For Mobile viewers with screen size of 360px or less, table below is best viewed in landscape view (horizontal) instead of portrait view (vertical).
Plan Plan Name Plan Cost* State Availability View Link(s)
UBA Membership Plan UBA Membership $10 for the
entire family
All 50 US States

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details.




UBA Membership Plan

UBA MEMBERSHIP PLAN

MEMBER DRIVEN VALUE.

Unlock the value of your UBA Membership.


Your membership in United Business Association (UBA) gives you access to lifestyle and business benefits and services like Lab Discounts, 24-hr Emergency Roadside Assistance, Office Supply Discounts and more as well as access to enroll in association group insurance programs and to apply for association short term medical insurance.

The UBA Membership Plan is an excellent fit for small business owners and employees and their families. Your membership in UBA offers you Member Driven Value.








Business Services of UBA
Business Services of UBA Membership

  • Car Rental Discount
  • TrueCar Buying Network
  • Graduate Scholarship Program
  • HopTheShops.com
  • 24-Hr Roadside Assistance
  • TravelerBonus.com
  • 1800Flowers.com Discounts
  • ADP Payroll Processing Service
  • Office Max Offices Supplies & Furniture Discounts
  • Hewlett (HP) Computers & Equipment
  • UPS Express Delivery Service
  • LegalConnect®
  • Choice Hotels Discounts
  • Apply for Business Insurance: Business Owner's Policy
  • Apply for Business Insurance: Data Breach & Cyber Liability








Lifestlye Services of UBA
Lifestyle Services of UBA Membership

  • 24-Hr Nurse Helpline
  • Health Savings Account with HSA Bank®
  • Lab Discounts
  • Gateway Medicard
  • LensCrafters Vision Club
  • Discount Hearing Service
  • Travel Assistance Plan
  • GymAmerica.com
  • Child ID Card Services
  • National Theme Park Discounts
  • Tickets at Work
  • Savings Perks Program








UBA Member Networking
Networking with UBA

Advertise your Small Business for FREE and network with other UBA Members. Don't have an ad? That's okay! UBA can create one for you.







THIS IS AN ASSOCIATION MEMBERSHIP PLAN.


Read the brochure carefully. This is a brief description of the membership services available to you in the United Business Association membership. Product features, additional plans, and availability may vary by state. While we believe you will be pleased with your overall association membership, we cannot, however, warrant or guarantee the performance of any discount or service. You must be a member of the United Business Association in order to purchase any plan that includes group association insurance issued to the United Business Association.



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Benefit Boost Plan Benefit Boost Plan Ind - $20
Ind+1 - $40
Family - $60
All 50 U.S. States

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Benefit Boost Plan

BENEFIT BOOST PLAN

IMPROVING HEALTH.

A strategy to boost your overall health.


The Benefit Boost Plan offers valuable services for those looking to seek immediate medical visits or talk therapy when you are sick or feeling down, looking to save on maintenance medications and to keep a healthy lifestyle with free vitamins, dental discounts and protection against identity theft.

Benefit Boost is a non-insurance strategy to boost your overall health.








Telehealth with MeMD
Telehealth Service with MeMD®

$0.00 Cost* to all Members

URGENT CARE TELEHEALTH

Ideal for common illnesses and minor injuries like allergies, flu symptoms, sinus symptoms, UTIs and more.

TALK THERAPY TELEHEALTH

MeMD's national provider network of licensed professional counselors, clinical social workers, marriage and family therapists are there to help with common teletherapy issues like abuse, addiction, anxiety, stress and more.

*Visits are paid by Healthy America and not by member.








Affordable Prescriptions with mailmypresriptions.com
Affordable Prescriptions with Mailmypresriptions.com®

Save up to 90% on your maintenance medications using mailmyprescriptions.com®. Shop drug prices online. All your orders ship FREE!








Free Gummy Multi-Vitamins
Free Gummy Vitamins

High quality multi-vitamins that come in strawberry and cherry gumdrops. They are free to all Members including shipping and come in a 90-day supply.



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Retail RX & Pet RX Discounts
Retail RX & Pet RX Discounts

Save on prescriptions at a participating retail pharmacy and also save on your pet medications with your Retail RX and Pet RX Discounts cards. Use the web tool to locate a participating pharmacy, get your discounted pharmacy pricing and research your drug and cost-effective alternatives.








Aetna Dental Access Discounts
Aetna Dental Access Discounts

Members can save 15% to 50%* per visit, in most instances, on services that any of the more than 161,000** available dental practice locations nationwide. Dental services include: cleanings, x-rays, fillings, root canals, and crowns. Members can also save on specialty care such as orthodontics and periodontics where available.

*Actual costs and savings vary by provider, service and geographical area.
**As of August 2015.








Identity Theft Protection with LifeLock
Identity Theft Protection with LifeLock®

Help protect your identity in our digitally-connect world. As a member, you can get over 20% off your first year of LifeLock membership*.

*Terms apply. Designated trademarks and brands are the properties of their respective owners.











THIS IS A MEMBERSHIP PLAN AND IS NOT INSURANCE.


Read the brochure carefully. This is a brief description of the membership services available to you in the Benefit Boost Plan membership. Product features and availability may vary by state. While we believe you will be pleased with your overall association membership, we cannot, however, warrant or guarantee the performance of any discount or service. These Benefit Boost services are included in any of the UBA Gap Plans that include insurance (except UBA Dental & UBA Vision Plans).



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Gap ER  Plan Gap ER Plan Ind - $35
Ind+1 - $55
Family - $65
AL, AZ, AR, CA, DC, DE, FL, GA, ID, IL, IN, IA, KY, LA, MI, MO, MS, NE, NM, NJ, NC, ND, OH, OK, PA, RI, SC, TN, TX, VA, VT, WV, WI & WY

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Gap ER Plan

GAP ER PLAN

FOR THE UNEXPECTED.

Emergencies happen when you least expect it.


The Gap ER Plan is valuable coverage for young families, people who tend to be accident-prone, or those that want that extra layer of protection for some of their out-of-pocket costs due emergency room visits for accident & sickness.

Gap ER Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Daily Hospital Confinement Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Emergency Room Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Includes visits at In-Hospital Emergency Rooms, Free Standing Emergency Rooms, and Licensed Urgent Care Centers.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Crum & Forster and United States Fire Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP HOSPITAL FIXED INDEMNITY INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP HOSPITAL FIXED INDEMNITY INSURANCE ONLY POLICY.


The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company. Your overall total association membership dues for the Gap ER Plan also include these monthly insurance rates:

Group Hospital Fixed Indemnity Insurance: $9.04 (Individual), $18.07 (Ind+1), $31.63 (Family)


Read the brochure and Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance. Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Plan cost does not include the separate $10 UBA Membership dues. Plan cost does include association information, awareness benefits, consumer savings, service programs, insurance premium, marketing and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Crum & Forster, United States Fire Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AH-2562



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Gap AME+ER  Plan Gap AME+ER Plan Ind - $40
Ind+1 - $65
Family - $90
AL, AZ, AR, CA, DC, DE, FL, GA, ID, IL, IN, IA, KY, LA, MI, MO, MS, NE, NM, NJ, NC, ND, OH, OK, PA, RI, SC, TN, TX, VA, VT, WV, WI & WY

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Gap AME+ER Plan

GAP AME+ER PLAN

ACCIDENTS HAPPEN.

Life is unpredictable and sometimes we get hurt.


The Gap AME+ER Plan is valuable coverage for young families, people who tend to be accident-prone, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident or emergency room visit.

Gap AME+ER Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Accident Insurance
Group Accident Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.








Daily Hospital Confinement Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Emergency Room Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Includes visits at In-Hospital Emergency Rooms, Free Standing Emergency Rooms, and Licensed Urgent Care Centers.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Crum & Forster and United States Fire Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP ACCIDENT & GROUP HOSPITAL FIXED INDEMNITY INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & GROUP HOSPITAL FIXED INDEMNITY INSURANCE ONLY POLICY.


The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company. Your overall total association membership dues for the Gap AME+ER Plan also include these monthly insurance rates:

Group Accident Insurance: $5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
Group Hospital Fixed Indemnity Insurance: $9.04 (Individual), $18.07 (Ind+1), $31.63 (Family)


Read the brochure and Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance. Group Accident and Group Hospital Fixed Indemnity Insurance are underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Plan cost does not include the separate $10 UBA Membership dues. Plan cost does include association information, awareness benefits, consumer savings, service programs, insurance premium, marketing and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Crum & Forster, United States Fire Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AH-2562



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Gap AME 10K Gap AME 10K Plan Ind - $25
Ind+1 - $35
Family - $45
Underwritten by Guaranteed Trust Life Insurance Company (GTL) - AL, AZ, AR, CA, CT, DC, DE, FL, GA, IL, IN, IA, KS, KY, MI, MS, NC, ND, NE, NJ, NV, OH, OK, PA, RI, SC, TN, TX, VA, WV, WI & WY

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Gap AME 10K Plan

GAP AME 10K PLAN

ACCIDENTS HAPPEN.

Life is unpredictable and sometimes we get hurt.


The Gap AME 10K Plan is valuable coverage for young families, people who tend to be accident-prone, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident.

Gap AME 10K Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Accident Only Insurance
Group Accident Only Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Benefit Maximum Benefit per injury.
$100 Deductible per injury.

Covered Services (as defined by policy) & Maximum Benefit:

  • We pay up to the Policy Limits - Hospital Room & Board, general nursing care, up to the semi-private room rate.
  • We pay up to the Policy Limits - Hospital miscellaneous expenses during the hospital confinement or for outpatient surgery under general anesthetic, such as the cost of the operating room, laboratory tests, x-ray exams, anesthesia, drugs (excluding take-home drugs), or medicines, therapeutic services and supplies.
  • We pay $1,000 - Doctor's fees for surgery.
  • We pay $250 - Anesthesia services.
  • We pay $75 - Doctor's visits per visit (inpatient & outpatient).
  • We pay $500 - Hospital Emergency care.
  • We pay $250 - X-ray and Laboratory service.
  • We pay $250 - Ambulance expense.
  • We pay up to the Policy Limits - Prescription drug coverage.
  • We pay $250 - Dental treatment for injury to sound natural teeth per tooth.
  • We pay up to the Policy Limits - Registered nurse expense.
  • We pay $20 - Chiropractic per visit.
  • We pay $25 - Physical therapy per visit.
  • We pay $50 - Durable medical equipement.

Group Accident Insurance is underwritten by Guarantee Trust Life Insurance Company (GTL).








Group Accident Only Insurance
Group Accident Only Insurance

Group Accidental Death & Dismembemberment Insurance

$1,000 Accidental Death & Dismemberment Benefit Principal Sum

Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Guarantee Trust Life Insurance Company (GTL) does not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP ACCIDENT ONLY INSURANCE UNDERWRITTEN BY:
Guarantee Trust Life Insurance Company


GTL Logo

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS GROUP ACCIDENT ONLY INSURANCE.


Read the brochure and Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance . Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Guarantee Trust Life Insurance Company (GTL) provides the Accident Medical Expense benefit and the Accidental Death & Dismemberment benefit. GTL does not provide nor is affiliated with the discount programs provided as part of membership in the United Business Association. The insurance described in this document provides limited benefits. Limited benefit policies are insurance products intended to help supplement comprehensive health insurance plans. This insurance is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, this insurance is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Plan Cost does not include the separate $10 UBA Membership dues. Plan cost does include Association information, awareness benefits, consumer savings, service programs, insurance rates (of $7.75 for Ind, $19.37 for Family), marketing and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

Guarantee Trust Life Insurance Company, United Business Association, and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AAD101.15-19



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Gap CI Plan Gap CI Plan Ind - $30
Ind+Sp - $60
Family - $60
AR, AZ, MS, MO, NM, OK, & TX

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Gap CI Plan

GAP CI PLAN

BE PREPARED.

Fight back against out-of-pocket expenses.


The Gap CI Plan is valuable coverage for those reaching middle age, for people with a family history of cancer, heart attack or stroke, or those that just want that extra layer of protection for some of their out-of-pocket costs due to being diagnosed with a Critical Illness.

Gap CI Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Critical Illness Insurance
Group Critical Illness Insurance

Maximum Benefit

$25,000 Critical Illness Maximum Lifetime Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Group Critical Illness Insurance is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company.








Group Critical Illness Insurance - Covered Critical Illnesses
Group Critical Illness Insurance

Covered Critical Illnesses

Heart Attack: An acute myocardial infarction resulting in the death of a portion of the heart muscle (myocardium) due to a blockage of one or more of the coronary arteries and resulting in the loss of normal function of the heart.

The diagnosis of a heart attack must be made by a Physician board-certified in Cardiology and based on both of:

  • New clinical presentation and/or electrocardiographic changes consistent with an evolving heart attack; and
  • Serial measurement of cardiac biomarkers showing a pattern and to a level consistent with a diagnosis of a heart attack.

Established (old) Myocardial Infarction is excluded.




Stroke: An acute cerebrovascular accident producing neurological impairment and resulting in paralysis or other measurable objective neurological deficit persisting for at least thirty (30) days.

This definition of stroke shall specifically exclude transient ischemic attack (mini-stroke), head injury, chronic cerebrovascular insufficiency and reversible ischemic neurological deficits. The diagnosis of a Stroke must be made by a Physician board-certified in Neurology.




Life-Threatening Cancer: Includes only those types of cancer manifested by the presence of a malignant tumor, characterized by the uncontrolled growth and spread of malignant cells that invade tissue, blood, or the lymphatic system. As used herein, Leukemia, and Hodgkin's Disease (except Stage 1 Hodgkin's Disease) shall be considered Life-Threatening Cancer.

Does not Include:

  • premalignant tumors or polyps;
  • cancer in situ
  • carcinoid of the appendix;
  • Stage 0 transitional carcinoma of urinary bladder; or
  • any skin cancers other than malignant melanomas.

Life-threatening cancer must be positively diagnosed by a physician certified by the American Board of Pathology to practice Pathologic Anatomy, or a certified Osteopathic Pathologist. Diagnosis must be based on a microscopic examination of fixed tissue or preparations from the hemic system (either during life or post-mortem). The pathologist establishing the diagnosis shall base his/her judgement solely on the criteria of malignancy as accepted by the American Board of Pathology or the Osteopathic Board of Pathology after a study of the histocytologic architecture or pattern of the suspect tumor, tissue, or specimen. Clinical diagnosis alone will not meet this standard.

Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company.








Exclusions - Group Critical Illness Insurance
Group Critical Illness Insurance

Exclusions

We do not pay any benefits:

  • For a Critical Illness that First Occurs before your Effective Date of Coverage.
  • If your coverage is not in force on the date the Critical Illness First Occurs.
  • If the Certificate is not in force on the date the Critical Illness First Occurs.
  • For any condition that is not diagnosed as a Critical Illness.

Benefits are paid on first diagnosis, as a lump sum payment, not paid based on actual expenses incurred and only if the Covered Critical Illness occurs after the Effective Date of Coverage for that Covered Person and while the Covered Person's coverage under this Group Policy is in force. We pay a Covered Critical Illness only one time, regardless of the subsequent occurrence of the same or different Covered Critical Illness for that Covered Person. Once the benefit is paid, coverage for that Covered Person under the Certicate ends. Please see policy for complete plan details.

Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Windsor Life Insurance Company does not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP CRITICAL ILLNESS INSURANCE UNDERWRITTEN BY:
Windsor Life Insurance Company


Windsor - Optimum RE Logo

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP CRITICAL ILLNESS INSURANCE ONLY POLICY.


Read the brochure and Certificate(s) of Insurance carefully. This is a brief description of Group Critical Illness Insurance and is not an insurance contract, nor part of the insurance policy. You’ll find complete coverage details in the policy certificate. Group Critical Illness Insurance pays for benefits for first diagnosis of Covered Critical Illnesses only and does not provide for any other medical conditions. You should maintain separate comprehensive health coverage. Group Critical Illness Insurance is provided by and underwritten by Windsor Life Insurance Company, an Optimum Re reinsured company. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Policy Certificate. Benefit for Group Critical Illness Insurance ends at 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date.

United Business Association, Optimum Re, Windsor Life Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.



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Gap Basic Plan Gap Basic Plan Ind - $30
Ind+1 - $50
Family - $70
AL, AR, AZ, CA, DE, GA, IL, IN, KS, KY, MI, MO, NJ, OK, RI, TX, WI & WV

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Gap Basic Plan

GAP BASIC PLAN

GAP YOUR DEDUCTIBLE.

Don’t break the bank for out-of-pocket medical expenses.


The Gap Basic Plan is valuable coverage for young families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident or being diagnosed with a Critical Illness.

Gap Basic Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Blanket Group Accident Insurance
Blanket Group Accident Insurance

Group Accident Medical Expense Insurance

$5,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$2,500 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Blanket Group Accident Insurance is underwritten by Sirius America Insurance Company.








Critical Illness Insurance Benefit - Group Hospital Fixed Indemnity Insurance
Group Critical Illness Insurance

Critical Illness Insurance Benefit

$5,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $1000 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Sirius America Insurance Company.








Group Term Life Insurance
Group Term Life Insurance

$5,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts (coming soon), and Identity theft protection with LifeLock® (coming soon).

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Sirius America Insurance Company and Investors Heritage Life Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

BLANKET GROUP ACCIDENT & GROUP CRITICAL ILLNESS INSURANCE ARE UNDERWRITTEN BY:
Sirius America Insurance Company


Sirius America Insurance Company Logo


GROUP TERM LIFE INSURANCE
PROVIDED BY:


Group Term Life Insurance provided by Investors Heritage Life Insurance Company

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. COVERAGE IS PROVIDED UNDER BLANKET ACCIDENT, GROUP CRITICAL ILLNESS AND GROUP TERM LIFE INSURANCE ONLY POLICIES.


The following monthly insurance rates apply to coverage underwritten by Sirius America Insurance Company. Your overall total association membership dues for the Gap Basic Plan also include these monthly insurance rates:

Blanket Group Accident Insurance: $4.17 (Individual), $8.37 (Ind+1), $15.76 (Family)
Group Critical Illness Insurance: $3.26 (Individual), $6.51 (Ind+1), $6.51 (Family)


Read the brochure and Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Accident Insurance and Group Critical Illness Insurance are underwritten by Sirius America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Group Critical Illness Insurance Benefit Maximum is reduced if the first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and covers member and eligible spouse only and coverage ends at age 65. Plan cost for the Gap Basic Plan does not include the separate $10 UBA Membership dues. Plan cost does include Association information, awareness benefits, consumer savings, insurance premium, marketing, and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Sirius America Insurance Company, Investors Heritage Life Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

HA-1000



^
TOP



GET ACCIDENT CLAIM FORM GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA

GET TERM LIFE CLAIM FORM
Gap Plus Plan Gap Plus Plan Ind - $40
Ind+1 - $60
Family - $80
AL, AR, AZ, DC, DE, FL, GA, IL, IN, IA, KY, LA, MI, MS, NE, NM, NC, ND, OH, OK, PA, RI, SC, TN, TX, VA, VT, WV, WI, & WY

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Gap Plus Plan

GAP PLUS PLAN

BRIDGING THE GAP.

Unexpected out-of-pocket medical expenses happen.


The Gap Plus Plan is valuable coverage for young families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke or those that just want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a Critical Illness or for doctor visits, labs, & x-rays.

Gap Plus Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Accident Insurance
Group Accident Insurance

Group Accident Medical Expense Insurance

$5,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$2,500 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.








Daily Hospital Confinement Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Physician Office Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Physician Office Visit Benefit

$125 per day Daily Physician Office Visit Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.

Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Outpatient Diagnositic Laboratory Tests Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Laboratory Tests Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.

Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Outpatient Diagnositic Radiology, X-ray & Imaging Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Radiology & X-Ray Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.

Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Critical Illness Insurance Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Critical Illness Insurance Benefit

$5,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Group Term Life Insurance
Group Term Life Insurance

$5,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Crum & Forster, United States Fire Insurance Company and Investors Heritage Life Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP ACCIDENT & GROUP HOSPITAL FIXED INDEMNITY INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo


GROUP TERM LIFE INSURANCE
PROVIDED BY:


Group Term Life Insurance provided by Investors Heritage Life Insurance Company

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE & GROUP TERM LIFE INSURANCE ONLY POLICY.


The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company. Your overall total association membership dues for the Gap Plus Plan also include these monthly insurance rates:

Group Accident Insurance: $5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
Group Hospital Fixed Indemnity Insurance: $7.98 (Individual), $15.66 (Ind+1), $19.90 (Family)
Critical Illness Insurance Benefit Rider: $3.00 (Individual), $6.00 (Ind+1), $6.00 (Family)


Read the brochure and Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and covers member and eligible spouse only and coverage ends at age 65. Plan cost for the Gap Plus Plan does not include the separate $10 UBA Membership dues. Plan cost does include Association information, awareness benefits, consumer savings, insurance premium, marketing, and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Crum & Forster, United States Fire Insurance Company, Investors Heritage Life Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AH-2562



^
TOP



GET ACCIDENT & WELLNESS CLAIM FORM GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA

GET TERM LIFE CLAIM FORM
Gap Max Plan Gap Max Plan Ind - $50
Ind+1 - $85
Family - $110
AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, VA, VT, WI, WV & WY

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Gap Max Plan

GAP MAX PLAN

MAX YOUR BENEFITS.

Expect the unexpected and be prepared.


The Gap Max Plan is valuable coverage for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke or those that just want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a Critical Illness or for emergency room & urgent care visits.

Gap Max Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Accident Insurance
Group Accident Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.








Daily Hospital Confinement Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Emergency Room Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Includes visits at In-Hospital Emergency Rooms, Free Standing Emergency Rooms, and Licensed Urgent Care Centers.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Critical Illness Insurance Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Critical Illness Insurance Benefit

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Group Term Life Insurance
Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Crum & Forster, United States Fire Insurance Company and Investors Heritage Life Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP ACCIDENT & GROUP HOSPITAL FIXED INDEMNITY INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo


GROUP TERM LIFE INSURANCE
PROVIDED BY:


Group Term Life Insurance provided by Investors Heritage Life Insurance Company

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE & GROUP TERM LIFE INSURANCE ONLY POLICY.


The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company. Your overall total association membership dues for the Gap Max Plan also include these monthly insurance rates:

Group Accident Insurance: $5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
Group Hospital Fixed Indemnity Insurance: $9.04 (Individual), $18.07 (Ind+1), $31.63 (Family)
Critical Illness Insurance Benefit Rider: $7.86 (Individual), $15.73 (Ind+1), $15.73 (Family)


Read the brochure and Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and covers member and eligible spouse only and coverage ends at age 65. Plan cost for the Gap Plus Plan does not include the separate $10 UBA Membership dues. Plan cost does include Association information, awareness benefits, consumer savings, insurance premium, marketing, and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Crum & Forster, United States Fire Insurance Company, Investors Heritage Life Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AH-2562



^
TOP



GET ACCIDENT & ER CLAIM FORM GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA

GET TERM LIFE CLAIM FORM
Gap Max Plan Gap Max Plan Ind - $50
Ind+1 - $85
Family - $110
AZ, MO & TX

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Gap Max Plan

GAP MAX PLAN

MAX YOUR BENEFITS.

Expect the unexpected and be prepared.


The Gap Max Plan is valuable coverage for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke or those that just want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a Critical Illness or for emergency room & urgent care visits.

Gap Max Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Accident Insurance
Group Accident Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.








Daily Hospital Confinement Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Emergency Room Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Includes visits at In-Hospital Emergency Rooms, Free Standing Emergency Rooms, and Licensed Urgent Care Centers.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Critical Illness Insurance Benefit - Group Hospital Fixed Indemnity Insurance
Group Critical Illness Insurance

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company.








Group Term Life Insurance
Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Crum & Forster, United States Fire Insurance Company, Windsor Life Insurance Company and Investors Heritage Life Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP ACCIDENT & GROUP HOSPITAL FIXED INDEMNITY INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo


GROUP CRITICAL ILLNESS INSURANCE
PROVIDED BY:


Group Critical Illness Insurance provided by Windsor Life Insurance Company


GROUP TERM LIFE INSURANCE
PROVIDED BY:


Group Term Life Insurance provided by Investors Heritage Life Insurance Company

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE & GROUP TERM LIFE INSURANCE ONLY POLICY.


The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company. Your overall total association membership dues for the Gap Max Plan also include these monthly insurance rates:

Group Accident Insurance: $5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
Group Hospital Fixed Indemnity Insurance: $9.04 (Individual), $18.07 (Ind+1), $31.63 (Family)


Read the brochure and the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance are underwritten by United States Fire Insurance Company, Eatontown, NJ. Group Critical Illness is underwritten by Windsor Life Insurance Company. Coverage for Critical Illness Insurance Benefit ends at age 65 and is available to Covered Member and Eligible Spouse only. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and is available to Covered Member and Eligible Spouse only and coverage ends at age 65. Plan cost for the Gap Max Plan does not include the separate $10 UBA Membership dues. Plan cost does include Association information, awareness benefits, consumer savings, insurance premium, marketing, and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Crum & Forster, United States Fire Insurance Company, Windsor Life Insurance Company, Optimum Re, Investors Heritage Life Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AH-2562



^
TOP



GET ACCIDENT & ER CLAIM FORM GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA

GET TERM LIFE CLAIM FORM
Super Gap Plus Plan Super Gap Plus Plan Ind - $60
Ind+1 - $120
Family - $140
AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, PA, RI, SC, TN, VA, VT, WI, WV, & WY

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Super Gap Plus Plan

SUPER GAP PLUS PLAN

GET IN THE FIGHT.

Fighting the battle against out-of-pocket costs.


The Super Gap Plus Plan is valuable coverage for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke or those that just want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a Critical Illness, emergency room & urgent care visits, doctor visits, labs and x-rays.

Super Gap Plus Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Accident Insurance
Group Accident Insurance

Group Accident Medical Expense Insurance

$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.








Daily Hospital Confinement Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Emergency Room Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Includes visits at In-Hospital Emergency Rooms, Free Standing Emergency Rooms, and Licensed Urgent Care Centers.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Physician Office Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Physician Office Visit Benefit

$125 per day Daily Physician Office Visit Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.

Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Outpatient Diagnositic Laboratory Tests Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Laboratory Tests Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.

Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Outpatient Diagnositic Radiology, X-ray & Imaging Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Radiology & X-Ray Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.

Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Critical Illness Insurance Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Critical Illness Insurance Benefit

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Group Term Life Insurance
Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Crum & Forster, United States Fire Insurance Company and Investors Heritage Life Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP ACCIDENT & GROUP HOSPITAL FIXED INDEMNITY INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo


GROUP TERM LIFE INSURANCE
PROVIDED BY:


Group Term Life Insurance provided by Investors Heritage Life Insurance Company

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE & GROUP TERM LIFE INSURANCE ONLY POLICY.


The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company. Your overall total association membership dues for the Super Gap Plus Plan also include these monthly insurance rates:

Group Accident Insurance: $5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
Group Hospital Fixed Indemnity Insurance: $11.36 (Individual), $22.69 (Ind+1), $36.85 (Family)
Critical Illness Insurance Benefit Rider: $7.86 (Individual), $15.73 (Ind+1), $15.73 (Family)


Read the brochure and Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and covers member and eligible spouse only and coverage ends at age 65. Plan cost for the Super Gap Plus Plan does not include the separate $10 UBA Membership dues. Plan cost does include Association information, awareness benefits, consumer savings, insurance premium, marketing, and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Crum & Forster, United States Fire Insurance Company, Investors Heritage Life Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AH-2562



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GET ACCIDENT, ER & WELLNESS CLAIM FORM GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA

GET TERM LIFE CLAIM FORM
Super Gap Plus Plan Super Gap Plus Plan Ind - $60
Ind+1 - $120
Family - $140
AZ, MO & TX

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Super Gap Plus Plan

SUPER GAP PLUS PLAN

GET IN THE FIGHT.

Fighting the battle against out-of-pocket costs.


The Super Gap Plus Plan is valuable coverage for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke or those that just want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a Critical Illness, emergency room & urgent care visits, doctor visits, labs and x-rays.

Super Gap Plus Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Accident Insurance
Group Accident Insurance

Group Accident Medical Expense Insurance

$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.








Daily Hospital Confinement Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Emergency Room Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Includes visits at In-Hospital Emergency Rooms, Free Standing Emergency Rooms, and Licensed Urgent Care Centers.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Physician Office Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Physician Office Visit Benefit

$125 per day Daily Physician Office Visit Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.

Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Outpatient Diagnositic Laboratory Tests Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Laboratory Tests Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.

Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Outpatient Diagnositic Radiology, X-ray & Imaging Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Radiology & X-Ray Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.

Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Critical Illness Insurance Benefit - Group Hospital Fixed Indemnity Insurance
Group Critical Illness Insurance

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company.








Group Term Life Insurance
Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Crum & Forster, United States Fire Insurance Company, Windsor Life Insurance Company and Investors Heritage Life Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP ACCIDENT & GROUP HOSPITAL FIXED INDEMNITY INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo


GROUP CRITICAL ILLNESS INSURANCE
PROVIDED BY:


Group Critical Illness Insurance provided by Windsor Life Insurance Company


GROUP TERM LIFE INSURANCE
PROVIDED BY:


Group Term Life Insurance provided by Investors Heritage Life Insurance Company

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE & GROUP TERM LIFE INSURANCE ONLY POLICY.


The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company. Your overall total association membership dues for the Super Gap Plus Plan also include these monthly insurance rates:

Group Accident Insurance: $5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
Group Hospital Fixed Indemnity Insurance: $11.36 (Individual), $22.69 (Ind+1), $36.85 (Family)


Read the brochure and the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance are underwritten by United States Fire Insurance Company, Eatontown, NJ. Group Critical Illness is underwritten by Windsor Life Insurance Company. Coverage for Critical Illness Insurance Benefit ends at age 65 and is available to Covered Member and Eligible Spouse only. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and is available to Covered Member and Eligible Spouse only and coverage ends at age 65. Plan cost for the Super Gap Plus Plan does not include the separate $10 UBA Membership dues. Plan cost does include Association information, awareness benefits, consumer savings, insurance premium, marketing, and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Crum & Forster, United States Fire Insurance Company, Windsor Life Insurance Company, Optimum Re, Investors Heritage Life Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AH-2562



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GET ACCIDENT, ER & WELLNESS CLAIM FORM GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA

GET TERM LIFE CLAIM FORM
Super Gap Plus Plan Super Gap Plus Plan Ind - $60
Ind+1 - $120
Family - $140
CA, ID & NJ

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




Super Gap Plus Plan

SUPER GAP PLUS PLAN

GET IN THE FIGHT.

Fighting the battle against out-of-pocket costs.


The Super Gap Plus Plan is valuable coverage for families, people who tend to be accident-prone or those that just want that extra layer of protection for some of their out-of-pocket costs due to an accident, emergency room & urgent care visits, doctor visits, labs and x-rays.

Super Gap Plus Plan is designed to help supplement your comprehensive health insurance plan for additional protection.








Group Accident Insurance
Group Accident Insurance

Group Accident Medical Expense Insurance

$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.
$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.








Daily Hospital Confinement Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Emergency Room Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Includes visits at In-Hospital Emergency Rooms, Free Standing Emergency Rooms, and Licensed Urgent Care Centers.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Physician Office Visit Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Physician Office Visit Benefit

$125 per day Daily Physician Office Visit Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.

Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Outpatient Diagnositic Laboratory Tests Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Laboratory Tests Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.

Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Daily Outpatient Diagnositic Radiology, X-ray & Imaging Benefit - Group Hospital Fixed Indemnity Insurance
Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Radiology & X-Ray Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

Max 1 day per play year for medically necessary visit and and additional 1 day for other Wellness visit.

Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.

Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.








Group Term Life Insurance
Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.








Benefit Boost Services
Benefit Boost Services

Non-Insurance Services included in this plan.

This plan includes Benefit Boost Services which are: telehealth with MeMD®, savings on prescriptions with mailmyprescriptions.com®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this membership plan.

Crum & Forster, United States Fire Insurance Company, and Investors Heritage Life Insurance Company do not offer and is not affliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP ACCIDENT & GROUP HOSPITAL FIXED INDEMNITY INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo


GROUP TERM LIFE INSURANCE
PROVIDED BY:


Group Term Life Insurance provided by Investors Heritage Life Insurance Company

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THE INSURANCE PORTIONS OF THIS PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE & GROUP TERM LIFE INSURANCE ONLY POLICY.


The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company. Your overall total association membership dues for the Super Gap Plus Plan also include these monthly insurance rates:

Group Accident Insurance: $5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)
Group Hospital Fixed Indemnity Insurance: $11.36 (Individual), $22.69 (Ind+1), $36.85 (Family)


Read the brochure and the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance are underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and is available to Covered Member and Eligible Spouse only and coverage ends at age 65. Plan cost for the Super Gap Plus Plan does not include the separate $10 UBA Membership dues. Plan cost does include Association information, awareness benefits, consumer savings, insurance premium, marketing, and administrative cost. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Crum & Forster, United States Fire Insurance Company, Investors Heritage Life Insurance Company and Healthy America are separate legal entities and have sole financial responsibility for their own products.

AH-2562



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TOP



GET ACCIDENT, ER & WELLNESS CLAIM FORM

Term Life States are: AL, AR, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA

GET TERM LIFE CLAIM FORM
UBA Dental Plan UBA Dental Plan Vary by state/area
Use Quote engine
at ubamembers.com
AL, AR, AZ, CA, CT, DC, DE, FL, GA, ID, IN, IA, KY, LA, MI, MS, MO, ND, NE, NJ, NM, NV, OH, OK, PA, SC, TN, TX, VA, VT, WV, WI & WY

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




UBA Dental Plan

UBA DENTAL PLAN

BRIGHTER SMILES.

Get regular cleanings and protect your oral health.


The UBA Dental Plan is valuable coverage for families, people who want to get regular dental check-ups, or those that just want that extra layer of protection for some of their out-of-pocket costs due to diagnostic & preventive, basic or major dental services.








Group Dental Insurance
Group Dental Insurance

$1,000 annual maximum
(Plus maximum carryover*)

$50 individual and $150 family annual deductible

*Maximum carryover: If at least one covered service is paid in a benefit year and the total benefit paid does not exceed $500 in that benefit year, $250 will be added to the next benefit year carryover maximum. This amount will accumulate from one benefit year to the next, but will not exceed $1,000




DIAGNOSTIC & PREVENTIVE

100% - Diagnostic & preventive services

In-network or out-of-network covearge (as defined by the policy).




BASIC SERVICES

70% - Basic dental services

In-network or out-of-network coverage (as defined by the policy).




MAJOR DENTAL SERVICES

50% - Major dental services

In-network or out-of-network coverage (as defined by the policy).

There is a 12 month waiting period for all major dental services.











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP DENTAL INSURANCE UNDERWRITTEN BY:
Renaissance Life & Health Insurance Company of America


Renaissance Dental

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THIS IS DENTAL INSURANCE AND NOT MAJOR MEDICAL INSURANCE.


Read the brochure and the group insurance certificates carefully. This is a brief description of Association Group Dental Insurance and is not an insurance contract, nor part of the insurance policy and is subject to the terms, conditions, limitations, and exclusions of the policy. Coverage may vary or may not be available in all states. You'll find complete coverage details in the policy certificate. Insurance benefits are underwritten by Renaissance Life & Health Insurance Company of America, Indianapolis, IN and in New York by Renaissance Life & Health Insurance Company of New York, Binghamton, NY. Both companies ("Renaissance") can be reached at Po Box 1596, Indianapolis, IN, 46206. There is no ownership affiliation between Renaissance and UBA Dental & Vision. For complete coverage details, please refer to the certificate of insurance. Plan cost for the UBA Dental Plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Renaissance Life & Health Insurance Company of America and Healthy America are separate legal entities and have sole financial responsibility for their own products.



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UBA Vision Plan UBA Vision Plan Ind - $14
Ind+1 - $27
Family- $43
AL, AR, AZ, CA, DC, DE, FL, GA, ID, IN, KY, LA, MI, MS, MO, ND, NE, NJ, NM, NV, OH, OK, PA, SC, TN, TX, VA, WV, WI & WY

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




UBA Vision Plan

UBA VISION PLAN

SEE MORE CLEARLY.

Get regular eye exams & take care of your eyes.


The UBA Vision Plan is valuable coverage for families, people who want to get regular vision check-ups, or those that just want that extra layer of protection for some of their out-of-pocket costs due to vision exams, frames, lenses, and contacts.








Group Vision Insurance
Group Vision Insurance

Well Vision Exam: $10 copay every 12 months

In-network coverage




Prescription glasses: $25 copay every 12 months

(see frames & lenses below) - in-network coverage




Frames: $130 allowance

In-network coverage

(for a wide selection of frames: 20% savings on amount over your allowance)

Lenses: single vision, lined bifocal, lined trifocal & lenticular lenses. Polycarbonate lenses for dependent children.




Lens enhancements - progressive lenses - every 12 months

In-network coverage

  • Standard: $55
  • Premium: $95-$105
  • Custom: $150-$175




Contacts (instead of glasses)

In-network coverage

  • Copay for contacts (applies to evaluation & fitting): up to $60 every 12 months
  • Allowance for contacts (copay does not apply): $130 allowance
  • Contact lens exam (evaluation & fitting): Medically necessary covered in full after $25 copay.

When contact lenses are obtained, the covered person shall not be eligible for lenses and frames again in the next 12 months.




Out-of-network Coverage:
Exams up to $45 & frames up to $70

Additional out-of-network coverage:

  • Single vision lenses: up to $30
  • Lined bifocal lenses: up to $50
  • Lined trifocal lenses: up to $65
  • Progressive lenses: up to $50
  • Lenticular lenses: up to $100
  • Contact lenses: up to $105 - (medically necessary contact lenses: up to $210)

Coverage with a retail chain affiliate may be different. Visit VSP.com for details if you plan to see a provider other than a VSP doctor.











ASSOCIATION BENEFITS
PROVIDED BY:


Association Benefits are provided by UBA

GROUP VISION INSURANCE UNDERWRITTEN BY:
Renaissance Life & Health Insurance Company of America


Renaissance Dental

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



THIS IS VISION INSURANCE AND NOT MAJOR MEDICAL INSURANCE.


Read the brochure and the group insurance certificates carefully. This is a brief description of Association Group Vision Insurance and is not an insurance contract, nor part of the insurance policy and is subject to the terms, conditions, limitations, and exclusions of the policy. Coverage may vary or may not be available in all states. You'll find complete coverage details in the policy certificate. Insurance benefits are underwritten by Renaissance Life & Health Insurance Company of America, Indianapolis, IN and in New York by Renaissance Life & Health Insurance Company of New York, Binghamton, NY. Both companies ("Renaissance") can be reached at Po Box 1596, Indianapolis, IN, 46206. There is no ownership affiliation between Renaissance and UBA Dental & Vision. For complete coverage details, please refer to the certificate of insurance. Plan cost for the UBA Vision Plan does not include the $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this plan.

United Business Association, Renaissance Life & Health Insurance Company of America and Healthy America are separate legal entities and have sole financial responsibility for their own products.



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GET VISION CLAIM FORM

Note: If using a VSP provider, claim form is not needed.

STM Plan - C&F STM Plan (C&F) Vary by age &
gender & zip
use quote engine
at ubamembers.com
6 months only:
AZ, MI, NV & WY

6 or 11 months only:
SC

6 or 12 months only:
AL, AR, GA, IA, KS, KY, MS, NC, NE, TX, WI & WV

(*Note: 12 months is only 364 days)

ALERT - if you are a current member and purchased your plan prior to 10-01-20, login to your member portal to review your plan details. The plan details listed below may be different from the plan you purchased.




STM Plan (C&F)

STM PLAN (C&F)

THE TIME IS NOW.

For times when you are without traditional health insurance.


United States Fire Insurance Company Short Term Medical Insurance provides coverage for unexpected medical bills and other health care expenses. Short Term Medical Insurance can be an excellent fit for those in-between coverage.








Individual Short Term Insurance
Individual Short Term Medical Insurance

Deductible: $5,000
(Deductible is per Covered Person per Coverage Period. Maximum of 3 Deductibles per family per Policy Period.)

Coinsurance Percentage: 20%
(% of covered expenses you pay after deductible to coinsurance limit.)

Coinsurance Limit: $10,000
(Coinsurance limit is after deductible, per person and copays are not included. Coinsurance limit is per person for all benefits.)

Policy Period Maximum: $1,000,000

Coverage period availability: 6 or 12 months
(12 month option is not available in all states. Also 12 month durations only cover 364 days and not 365 days.)

The deductible, coinsurance percentage, coinsurance limit, copays and policy period maximum apply to each Covered Person for ALL benefits, unless otherwise stated for a specific benefit listed in the policy.

To view all eligible medical benefits and their details, please review the policy and brochure.








Short Term Medical Insurance
Short Term Medical Benefit Highlights

Hospital, surgery, pregnancy & childbirth, diagnostic testing, radiology & labs, cancer screening & more.

Subject to deductible, coinsurance perentage and coinsurance limit








Short Term Medical Insurance
Short Term Medical Benefit Highlights

Emergency Room Benefit

Additional $250 Deductible per visit

(applied to charges for use of emergency room in the event of accident, injury, or sickness unless the Covered Person is directly admitted as in inpatient for further treatment.)








Short Term Medical Insurance
Short Term Medical Benefit Highlights

Physician Office Visit

$50 Copay for each visit

(Coinsurance will not apply, not subject to the deductible.)








Short Term Medical Insurance
Short Term Medical Benefit Highlights

Urgent Care Center

$50 Copay for each visit after which Coinsurance will apply

(Not subject to the deductible.)








Short Term Medical Insurance
Short Term Medical Benefit Highlights

Local Ambulance

Injury (when related to covered injury)

Sickness (When covered sickness results in hospitalization as inpatient)

Maximum of $250 per trip













ENDORSED BY:


Association Benefits are provided by UBA

SHORT TERM MEDICAL INSURANCE UNDERWRITTEN BY:
United States Fire Insurance Company


Crum & Forster Logo

BILLING, FULFILLMENT & CUSTOMER SERVICE PROVIDED BY:


Healthy America Logo



STM PLAN (C&F) DISCLAIMER

THE COVERAGE IS A SHORT TERM MEDICAL INSURANCE POLICY THAT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD.

NOTE: THE POLICY IS NOT RENEWABLE. NO CONTINUOUS COVERAGE. THE POLICY OF INSURANCE PROVIDES COVERAGE FOR SHORT TERM DURATION ONLY. IT IS NOT RENEWABLE. ALTHOUGH THIS SHORT TERM PLAN MAY BE WRITTEN FOR NEW AND COMPLETED SEPARATE COVERAGE PERIODS (AS LONG AS YOU MEET THE ELIGIBILITY CRITERIA DESCRIBED IN THE APPLICATION), COVERAGE DOES NOT CONTINUE FROM ONE POLICY TO ANOTHER. THIS MEANS THAT A NEW APPLICATION MUST BE SUBMITTED, A NEW EFFECTIVE DATE IS GIVEN, A NEW PREEXISTING CONDITION EXCLUSION PERIOD BEGINS AND A NEW DEDUCTIBLE AND OUT-OF-POCKET EXPENSE MUST BE MET. ANY MEDICAL CONDITION WHICH MAY HAVE OCCURRED AND/OR EXISTED UNDER A PRIOR POLICY WILL BE TREATED AS A PREEXISTING CONDITION UNDER THE NEW POLICY.


Read the brochure and Policy carefully. This is a brief description of Short Term Medical Insurance and is not an insurance contract, nor part of the insurance policy and is subject to the terms, conditions, limitations, and exclusions of the policy. Coverage may vary and may not be available in all states. You'll find complete coverage details in the policy. Short Term Medical Insurance is underwritten by United States Fire Insurance Company. Short Term Medical does not meet Minimum Essential Coverage as mandated by the Affordable Care Act. Short Term, limited duration plans are not subject to certain provisions of federal health care reform, including provisions related to Essential Health Benefits, lifetime limits, preventive care, guaranteed renewability, and preexisting conditions. The preexisting condition exclusion for Short Term Medical plans will apply for all insureds, including those under the age of 19. Know your plan. Short Term Medical plans offer medical coverage, are medically underwritten (so you can be declined) and do not provide Minimum Essential Coverage.

AH-2562



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GET STM PLAN CLAIM FORM

Note: You only need to file a claim form the first time seeing a new provider under this insurance.
You won't need to file a claim form for services provided by that same provider for any future visits.


*As outlined in the Plan Cost column of the table above, the plan cost for UBA Plans do not include the $10 monthly UBA Membership dues. You must be a member of the United Business Association in order to purchase a plan that includes group insurance. Plan cost does include Association information, awareness benefits, consumer savings, service programs, insurance rates, marketing and administrative cost. The $10 UBA Membership monthly membership dues do not apply to stand-alone Benefit Boost Plan or STM Plan (C&F). All plan costs are charged every month through the following methods: Credit Card (VISA, MasterCard or AMEX) or Bank Draft (EFT) until cancellation.



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