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The following limited benefit insurance is under the Group Accidental Death and Dismemberment and Medical Care Insurance policy and is an added benefit of your membership based upon the plan selected featuring:

Doctor Visits** - Pays a benefit amount per visit to a doctor’s office to be diagnosed or treated for a covered accident or sickness. You will be paid for up to a certain number of visits per person or per family per year.

Ambulance Benefit** - Pays a benefit amount per transport for a maximum of 3 transports per person per year.

Daily Hospital Benefit** - Pays a benefit amount per day for up to 180 days if you have to be admitted and stay in a hospital to treat you for a covered accident or sickness.

ICU Daily Benefit** - Pays a benefit amount per day for up to 14 days if you are confined to an intensive care unit in a hospital to treat you for a covered accident or sickness.

Surgical Benefit** - Pays benefits according to the surgical schedule as set forth in the description of coverage provided in your membership materials.

Emergency Room** - Pays a benefit amount each time it is necessary for you or your covered dependents (if this is a family membership) to get treatment for a covered accident or sickness by visiting the Emergency Room of a hospital. You will be paid for up to 3 visits per person per year.

Accident Medical Benefit - Pays part of the expenses you are charged by a hospital, doctor, or certain other charges, up to a maximum benefit amount if you are injured in a covered accident. Subject to a $100 deductible.

Accident Disability Benefit* - Pays a monthly benefit for total disability resulting from a covered accident. Benefits are payable for up to 12 months and are subject to a 90 day waiting period.

Accidental Death & Dismemberment - Pays the beneficiary up to the benefit amount for the member’s death or loss of certain body parts in a covered accident or a portion or that amount for the accidental death of a family member, if this is a family membership, (50% for covered spouse, 20% for covered dependent children).

*All benefits provided by this insurance are subject to the terms, definitions, conditions, exclusions and limitations, of the group policy. To obtain more information about this insurance, please call 1-866-445-1445 and ask to speak to a licensed agent. All members of this program are enrolled into the Consumer Assistance Services Association to be eligible to receive these benefits. These insurance benefits are underwritten by The United States Life Insurance Company in the City of New York, under Group AD&D & Medical Care Insurance Policy (Form #G-19000) issued to Consumer Assistance Services Association. Coverage is not provided for loss due to a pre-existing condition for 12 months from the Covered Person’s effective membership date.

The underwriting risks, financial and contractual obligations and support functions associated with the products issued by The United States Life Insurance Company in the City of New York are its responsibility. Coverage becomes effective on the date provided in your membership materials.

MA residents: this is not Creditable Coverage.

*Accident Disability coverage is not provided for members over the age of 69.

**Coverage is not provided for members over the age of 64.

THIS IS NOT BASIC HEALTH INSURANCE.THIS OFFER INCLUDES DISCOUNTS AND/OR SERVICES PLUS ADDED LIMITED BENEFIT INDEMNITY INSURANCE. NONE OF THESE, INDIVIDUALLY OR IN COMBINATION ARE A SUBSTITUTE FOR BASIC HEALTH COVERAGE, MAJOR MEDICAL INSURANCE OR ANY OTHER MEDICAL EXPENSE REIMBURSEMENT INSURANCE PLAN.