Accident
Baldwin County Schools offers two accident plan options through MetLife to protect you from unexpected accidents, as it can be difficult to financially plan for the unexpected. This plan provides a benefit payable according to a schedule, and the funds may be used for any purposes, including helping to pay for medical out-of-pocket costs like deductibles and coinsurance.
This plan reimburses you for your actual medical expenses and the benefit is paid directly to you. Coverage options are available for you, your spouse, and your dependent child(ren). It also includes a benefit for death, loss of limbs, hospital visits, and transportation by ambulance – as a result of a covered accident.
| Injury | Standard Plan | Premium Plan |
|---|---|---|
|
Medical Treatment Benefits
|
||
| Emergency Room | $150 | $200 |
| Physician's Office Visit | $75 | $100 |
| Medical Testing | $150 | $200 |
| Therapy | $35 | $50 |
| Surgery | $750 - $1,500 | $1,500 - $2,000 |
| Outpatient Surgery | $300 | $400 |
|
Hospital Benefits
|
||
| Admission | $1,000 | $1,500 |
| Confinement | $200 / day up to 15 days | $300 / day up to 15 days |
| Inpatient Rehabilitation | $150 | $200 |
|
Injury-Based Benefits
|
||
| Closed Fractures | From $100 to $4,000 | From $200 to $5,000 |
| Open Fractures | From $200 to $8,000 | From $400 to $10,000 |
| Dislocations | From $100 to $8,000 | From $200 to $10,000 |
| Lacerations | From $50 to $400 | From $75 to $700 |
| Concussions | $250 | $500 |
| Burns | From $75 to $10,000 | From $100 to $15,000 |
| Eye Injury | $300 | $400 |
|
Accidental Death & Dismemberment (AD&D)
|
||
| Basic Accidental Death | Employee: $25,000 Spouse: $12,500 Child: $5,000 | Employee: $50,000 Spouse: $25,000 Child: $10,000 |
| Loss of limbs, sight, hearing, ability to speak | Up to $20,000 Refer to complete schedule | Up to $40,000 Refer to complete schedule |
|
Sports Accident Benefit
|
||
| Covers accident as a result of an organized sporting activity | Pays an additional 25% of the benefit | Pays an additional 25% of the benefit |
Important Notes
- Employees are eligible regardless of age
- Four tiers are available to ensure you have the best fit for your family
- Coverage for eligible child dependent(s) is up to age 26
- Benefits reduce due to age at 65 (25%) and at age 70 (50%)
Exclusions
All sicknesses including pregnancy, work-related injuries, services not medically necessary, being intoxicated in accordance with state laws, alcoholism, voluntary inhalation of gas/fumes/taking of poison, driving in any race or speed test or while testing an automobile or vehicle on any racetracks or speedway, injury while skydiving, hang gliding, parachuting, scuba diving, rodeo, or aviation except flight in a scheduled passenger aircraft, being under the influence of a narcotic/drug, intentionally self-inflicted injury, hernia, carpel tunnel syndrome, or any complication therefrom, bacterial infections.
