As an ROA Member in good standing under age 70, you are guaranteed acceptance for up to a $250,000 AD&D benefit, payable for a covered accident. Your spouse¹ and children can be covered for a percentage of your chosen benefit. The plan also provides benefits for education, child care assistance and seat belt usage. Double benefits (up to $300,000) will be paid if you die in a covered accident while a passenger in a licensed common carrier (such as a taxicab, train, bus or airplane).

AD&D coverage is becoming a more popular way to supplement other insurance coverage you already have. And ROA Members are choosing the ROA Enhanced AD&D Plan for these important reasons:

• It's Easy to Get - You're Guaranteed Acceptance As an ROA Member under age 70, you're guaranteed this coverage. No health questions asked. No physical exam is required. This makes it much easier to get than some life and health insurance plans. Your spouse¹ and children under age 22 (26 if a full-time student) are guaranteed acceptance for this coverage, too!
• Pays a Lump Sum Accidental Death Benefit If you die from a covered accident, your loved ones can receive the benefit in one lump sum. No monthly or partial payments. Just one payment.
• Economical Group Rates DON’T Increase With Age Unlike many life insurance and medical plans that increase rates as you age, the ROA Enhanced AD&D plan’s rates don’t. ROA AD&D benefits costs up to 90 cents a day …add your spouse¹ and children for up to 35 cents a day.

 

ROA AD&D Insurance Plan (Monthly Rates)
Benefit Amount	Member Rate	Member & Family Rate
$100,000.00	$5.40	$7.50
$150,000.00	$8.10	$11.25
$200,000.00	$10.80	$15.00
$250,000.00	$13.50	$18.75
$500,000.00	$27.00	$37.50

 

*You will be billed semi-annually. If applicable, an additional $2 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.

Benefits may be changed on a class basis. Rates shown are guaranteed until 10/31/2023.
 

Family Coverage

Because accidents can happen to anyone, ROA suggests you get maximum coverage for your loved ones. Your spouse¹ and dependent children (under age 22, or under age 26 if a full-time student) are also guaranteed coverage. Your spouse¹ benefits are 40% of the benefit amount you choose and dependent child(ren)’s benefits are 10% of your benefit. If you are unmarried, each dependent child’s coverage will be 15% of your benefit. If you have no children, your spouse¹ benefits are 50% of your coverage.
 

ADDITIONAL Benefits Included

With this enhanced plan, your loved ones can collect additional benefits on top of the lump sum benefit for specific situations. For example, if you select $100,000.00 in benefits, your beneficiaries could receive extra benefits for the following:

• $50,000.00 Common Carrier Benefit: If your covered accidental death is a result of traveling as a fare-paying passenger or boarding or debarking a licensed common carrier (plane, train, taxi, etc.).
• $25,000.00 Safe Driver Benefit: If you have a covered fatal car accident and were wearing a seat belt at the time. This benefit increases to $40,000.00 if the car you were in or driving had factory-installed airbags that operated properly upon impact.
• $2,500.00/Year Child Care Benefit: If you have children under age 13 in daycare, the plan pays this amount each year for up to six years for each child.
• $5,000.00 Children's Education Benefit: Your children can receive this benefit each year for up to four years to continue their education.
   

How Your ROA Enhanced Benefits Could Add Up:

Suppose an individual runs a red light and hits a member's car head on and as a result, the member dies in a covered accident. The member leaves behind a spouse¹, twin daughters in child care and an older son in his first year of college. His family could collect:

• $100,000 Lump Sum Accident Benefit
• $40,000 Safe Driver Benefit
• $15,000 Child Care Benefit for Child #1 ($2,500/year for 6 years)
• $15,000 Child Care Benefit for Child #2 ($2,500/year for 6 years)
• $20,000 Education Benefit for Child #3 ($5,000/year for 4 years)

 

$190,000.00 TOTAL ROA Enhanced AD&D Benefit Paid
 

Pays Benefits for Other Specific Losses too: If you lose some or all of your limbs, eyesight or hearing due to a covered accident, you can collect partial benefits. Your Certificate Schedule of Benefits will provide all the details.
 

Automatic Beneficiary: Your beneficiary for death benefits will be your legal spouse¹, if living. If you have no spouse¹, your beneficiary will be your child(ren), parents, or siblings, in that order. If you wish to make other beneficiary arrangements, please contact the Plan Administrator in writing. You are automatically the beneficiary for spouse¹ and children coverage and for benefits other than death.
 

TERMINATION

You may maintain your ROA Group Accidental Death and Dismemberment Insurance coverage until age 80, as long as the Group Policy remains in force, you remain an ROA Member, and pay your premium on time. Coverage for your dependents terminates when your coverage ends, you stop paying premiums, or they are no longer eligible due to change in age, dependency, or marital status.
 

EXCLUSIONS

ReliaStar Life does not pay benefits for loss directly or indirectly caused by any of the following:

• An accident occurring before the Effective Date of the Group Policy.
• Suicide or intentionally self-inflicted injury, while sane or insane.
• Physical or mental illness.
• Bacterial infection or bacterial poisoning. Exception: Infection from a cut or wound caused by an accident.
• Riding in or descending from an aircraft as a pilot or crew member.
• Any armed conflict, whether declared as war or not, involving any country or government.
• An accident which occurs when you commit or attempt to commit a crime.
• Use of any drug, narcotic or hallucinogenic agent, unless prescribed by a doctor or taken as directed by a doctor or the manufacturer.
• Your or your insured dependent's intoxication. Intoxication means your or your insured dependent's blood alcohol content meets or exceeds the legal presumption of intoxication under the laws of the state where the accident occurred.

 

¹In OR, spouse includes domestic partner.

 

This is a summary of benefits only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of coverage. All coverage is subject to the terms of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern.
 

AD&D Insurance coverage is provided under the terms of a group life insurance policy, Group Policy GL-31816-7, issued and delivered in the state of North Dakota, and governed by its laws, to ROA as the policyholder. The group life insurance policy is issued by ReliaStar Life Insurance Company, Minneapolis, Minnesota. The policy is powered on behalf of ReliaStar Life Insurance Company by AMBA, an insurance manager licensed in the state of North Dakota. Policy form LP08GP.
 

This is a paid endorsement. ROA receives a fee from the insurance broker and/or the insurer for its endorsement of this plan.