Accident Summary

ACCIDENT Accident Ultra Bene昀椀t Summary PLAN OVERVIEW INFORMA吀䤀ON Hours Worked: 30+ hours/week* Employer Contribu琀椀on: Voluntary Accident insurance provides payment for medical Eligible Group Size: 50-100 eligible employees** expenses due to a non-occupa琀椀onal accidental Par琀椀cipa琀椀on Requirement: injury. Payment is made directly to the employee 10 lives for groups with 50-100 eligible employees regardless of other health insurance coverage. *An employee must be actively at work on the effective date in order to be eligible for bene昀椀ts. Employers located in New York may elect a minimum of 20 or 30 hours. COVERED ACCIDENTAL INJURIES Sudden, unexpected, unintended, claimant had no control over, and not workplace related. Refer to the policy cer琀椀昀椀cate for a speci昀椀c list of excluded accidents. bene昀椀t period Medical expenses must be incurred within 180 days from the date of the covered accident LOSS period First treatment must occur within 30 days from the date of the covered accident. ANNUAL BENE䘀䤀T MAXIMUM Individual Aggregate Employee $3,000 $3,000 EE + Spouse $3,000 $6,000 EE + Children $3,000 $9,000 Family $3,000 $9,000 BEAM SUPPORT LEARN MORE support@beambene昀椀ts.com (800) 648 1179 beambene昀椀ts.com BM-SOB-0010-202401 Valid as of 11/15/22