The issue of Long-Term Care is one that may affect almost all of us in one way or another. The costs associated with nursing home and home health care continue to escalate. Traditional sources of health coverage such as FEHB, Medicare, or Medicaid cover few if any long-term care expenses. Long-term care costs average over $50,000 per year and may be more depending on where you live. Have you considered how these high costs would impact your and/or your spouses financial situation?

The USDA/ESRA Supplemental Health Insurance Plan (SHIP)

Up to $250,000 of Protection at Affordable Group Rates

Protect your family against the losses that may result from an Accident. There are no health questions and your premium does not go up with age. Acceptance is automatic!

For the wise man or woman, inexpensive Accidental Death and Dismemberment (AD&D) insurance provides security and peace of mind. When income is lost because of covered accidental injury or death, AD&D provides a monetary bridge for families to get them through the troubled times. It can help compensate for a major decline in lifestyle and income as a result of a covered injury or it can provide a critical source of emergency funds to survivors in the event of an accidental death.

Accidental Death and Dismemberment insurance offers the extra coverage you and your family need to meet and overcome sudden unexpected problems.

Up to $250,000 of Coverage!
You and your spouse are eligible to enroll in the USDA/ESRA sponsored AD&D plan for benefits up to $250,000 at very affordable rates! Under this plan you are covered 24-hours a day anywhere in the world, whether you are at home, at work, or on vacation. You are also covered when traveling on business or for pleasure, including when you are flying as a passenger (but not as a crew member or pilot) on any commercial aircraft licensed to carry passengers, except aircraft owned, leased or operated by or on behalf of your employer. Each of your children may also be insured for AD&D benefits. And these benefits are payable in addition to any other insurance you have.

Additional Benefits
The following benefits are designed to provide you and your family with extra protection and are payable in addition to AD&D benefits.

Double Benefits for Common Carrier
If you or your covered dependents are injured while riding as a passenger on a common carrier, the amount of principal sum payable under the AD&D benefit will be doubled, to a maximum of $250,000. A common carrier is a vehicle operated by a business organization and licensed to transport passengers for hire, and operated by an employee of that business.

Seat Belt Benefit
If you suffer a loss payable under the Accidental Death and Dismemberment Benefit, the plan will pay an additional benefit of 10% of the AD&D benefit amount payable, to a maximum amount of $10,000 if injury occurred: while you were a passenger in or the licensed operator of a registered automobile and while wearing a Seat Belt, as verified in the police accident report.

This benefit does not cover loss if you are operating the automobile under the influence of any intoxicant, excitant, hallucinogen, narcotic or other drug, or similar substance as verified in the police accident report.

Permanent Total Disability Benefit
Pays a monthly benefit of 1% of the AD&D benefit amount, less any amount payable under the Accidental Death and Dismemberment Benefit, if you provide written proof that you were Totally Disabled from an Injury you received prior to age 70, the disability began within 365 days of the accident, the disability continued without interruption for 12 months and is expected to continue uninterrupted throughout the covered person's lifetime.

Totally Disabled means your inability to perform the material and substantial duties of any occupation for which you are suited by education, training and experience.

Education Benefit
If your spouse and/or children are covered under this plan and the AD&D benefit is payable because of your or your covered spouse's death, the plan will pay an Education Benefit to each eligible dependent child who qualifies. To receive this benefit, an eligible dependent child must show proof that on the date of your death he or she was enrolled as: a full time post-high school student in a school for higher learning; or a student in 12th grade and, within 365 days, enroll as a full-time post-high school student in a school for higher learning.

The Education Benefit will be the lesser of 2% of your AD&D benefit amount or $2,500. This benefit is payable every year in which an eligible dependent child meets the above definition for up to 4 consecutive years, provided the dependent child submits proof of his or her student status each year. If an Education Benefit would be payable, but no person qualifies as a student, the plan will pay $1,000 to your beneficiary.

Spouse Education Benefit
If your spouse is covered under this plan and the AD&D benefit is payable because of your death, the plan will pay an Education Benefit to your spouse. This benefit will be the lesser of the Expense Incurred for Occupational Training, or $3,500.

To qualify for this benefit, your spouse must enroll in an Occupational Training Program for the purpose of earning an independent income. Enrollment must take place within one year of your death, and expenses must be incurred within two years of your death.

Common Disease Benefit
If both you and your spouse die as a result of Injuries received in the same accident and the AD&D benefit is payable for each death, the benefit for your spouse will be increased to equal your AD&D benefit amount to a maximum combined benefit of $500,000.

Who is Eligible?
All active members of the USDA and their lawful spouses who are under 70 are eligible to enroll in this plan. You may also insure your unmarried dependent children who are under age 19 (age 25 if they are full-time students at school and primarily dependent upon you for support). If your spouse is also an eligible member and you both enroll, you cannot be dependents under each other's coverage. Children will be considered eligible dependents of both spouses.

Benefits for Accidental Death and Dismemberment
If any of the following losses result from an Injury sustained in an accident, and the loss occurs within 365 days after that accident, this plan will pay:

The total limit of liability for any one person for all losses due to the same accident will not be more than 100% of the benefit amount.

Your Annual Premiums

When you choose to protect your whole family, your spouse may be covered for either 100% or 50% of your benefit. Each dependent child will be covered for 10% of your benefit amount.

The benefit amounts shown will be reduced to 70% of the original amount at age 70; to 45% at age 75; 30% at age 80; and to 15% of the original amount at age 85.

Exclusions
Loss resulting from sickness or diseases, or medical or surgical treatment of a sickness or a disease, is not covered. Loss caused by any of the following events is not covered: (a) Intentionally self-inflicted injury, suicide or attempted suicide, whether sane or insane (in Missouri, while sane); (b) War or act of war, whether declared or not; (c) Injury sustained while full-time in the armed forces of any country or international authority; (d) Injury sustained while riding on any aircraft, unless it's a civilian or public aircraft, or military transport aircraft; (e) Injury sustained while riding on any aircraft as a pilot, crew member, student pilot, flight instructor or examiner; (f) Injury sustained while riding on any aircraft owned, operated or leased by or for the policyholder or any employer or organization whose eligible persons are covered under the policy; (g) Injury sustained while voluntarily taking drugs which federal law prohibits dispensing without a prescription, including sedatives, narcotics, barbiturates, amphetamines, or hallucinogens, unless the drug is taken as prescribed or administered by a licensed physician; (h) Injury sustained while committing or attempting to commit a felony; (i) Injury sustained as a result of being legally intoxicated from the use of alcohol.

Effective Date of Coverage
Your coverage will become effective on the later to occur: the Policy Effective date or the first day of the month on or next following the date your enrollment form and premium payment are received. Dependent coverage goes into effect on the date you become insured; on the first day of the month following receipt of your dependent's enrollment form; or on the date they become eligible, whichever is latest.

Coverage will continue as long as the group policy remains in effect, you remain a member of the association and you make premium payments. In addition, coverage for your spouse and dependent children will terminate when you cease to be insured or they are no longer eligible.

Beneficiary
Benefits for loss of your life will be paid to the beneficiary you have designated. If you have not designated a beneficiary, the life benefit will be paid in equal shares to the first of your survivors in the following order:

• First to your spouse
• Second, to your children
• Third, to your parents
• fourth, to your brothers and sisters

If there are no survivors in these classes, payment will be made to your estate. Benefits for loss other than life will be paid to you, and all dependent benefits are payable to you.

Administered by:

Mass Benefits Consultants, Inc.
P.O. Box 828
Annandale, VA 22003-0828

Call toll-free 1-800-221-3083

PROFESSIONAL LIABILITY INSURANCE

Especially designed for Federal Employees

Lawsuits against Federal Government employees are increasing at an alarming rate. Members of the public, even fellow workers, can bring personal lawsuits against you. You are at risk whenever you are acting within the scope of your job including:

• delegating assignments
• making staff evaluations
• working at your desk
• meeting with the public

Away from your desk, you could be exposed to even greater risk of lawsuits from private citizens. Frivolous or not, it could still cost you thousands of dollars.

Federal Law requires that all federal agencies
must reimburse employees one-half of the annual
premium for Professional Liability Insurance.
(Passed in 1996, part of the Omnibus Consolidated
Appropriations Act for Fiscal Year 1997
Contact your payroll office for reimbursement details)

The Federal Tort Claims Act states that the government can choose whether or not to defend you. It cannot cover any monetary damages awarded against you personally. Even if the Justice Department refuses to defend you, this plan picks up the full cost of your legal defense and pays covered damages awarded against you (up to the $1 million limit).

This Professional Liability Insurance was specially designed to protect Federal Government employees. You are protected anywhere in the world against losses from lawsuits stemming from the performance of your official federal duties.

In recent years, the number of disciplinary and performance-based actions taken by U.S. government agencies against their own employees, both supervisory and non-supervisory, has risen dramatically. Allegations of discrimination, sexual harassment, civil rights violations, computer and credit card misuse, leave abuse and other offenses can be leveled at the most honest and upright of people. This policy provides experienced federal employment law practitioners for your legal defense with coverage up to $100,000 in attorney fees and related costs. Both administrative and criminal charges against you are covered.

In the event defense of the Insured in any claim or suit is granted by the Department of Justice or its designee, the Insured may, nevertheless request the Company to provide him with an attorney selected by the Company to monitor and oversee the defense being provided by the United States.

ELIGIBILITY

Any full-time employee of the Federal Government working at least 17.5 hours per week is eligible for Professional Liability coverage

DESCRIPTION OF BENEFITS

• $1,000,000 of professional liability coverage for judgments arising from acts, errors, or omissions committed by you within the course and scope of your employment.
• Protection against judgments involving personal injury, bodily injury and property damage within the scope of your employment.
• Protection against lawsuits that existed before the effective date of coverage provided as an insured that you had no knowledge of such suits.
• A discovery period of 36 months is effective the day you retire.
• Administrative legal defense coverage up to $100,000 to pay the costs of defense and monetary penalties during administrative proceedings for acts committed or alleged within the scope of your employment. Coverage is provided for Internal Agency Disciplinary Proceedings; Criminal Proceedings; and Judicial Sanctions for any monetary penalty.

This plan pays for your defense cost even against groundless or fraudulent suits. This is in addition to your liability limit and is without limitation. There is no deductible, and where allowed by state law, this plan pays punitive damages up to your coverage limit.

JUSTICE DEPARTMENT CONSULTED IN DESIGNING THIS COVERAGE

This program was developed with the advice and consultation of attorneys in the Torts Claims Division of the Justice Department to provide the fullest protection possible for you as a government employee. They work in the field daily and are more acutely aware of your needs than anyone else. You should feel confident knowing this is the only professional liability policy developed with the advice of the Justice Department.

“Course and scope of employment” means an “incident” of any kind or character that has to do with and originates in the work, services, trade or profession of the employee’s federal agency and that is performed by the employee while engaged in or about the furtherance of the affairs or services of that federal agency.

ENROLLMENT

1. Complete and return the enclosed application form with payment in the return envelope provided (payroll deduction must be started by employee – call 1-800-221-3083 for assistance).

2. To pay by credit card, visit our secure website: www.career-guard.com. Complete the on-line application and credit card information.

Coverage will begin on the first day of the month following receipt of the application and payment. (Payroll Deduction Option – Coverage begins on the first day of the pay period that the deduction is made.)

EXCLUSIONS

Coverage under this plan does not apply

a) to any obligation for which the Insured or any carrier as the insurer may be held liable under any workers' compensation, unemployment compensation, disability benefits law, or other similar law;

b) to damages arising out of the willful violation of a penal statue or penal ordinance committed by or with the knowledge or consent of the Insured, or damages arising out of acts of fraud committed by or at the direction of the insured with affirmative dishonesty or actual intent to deceive or defraud;

c) to liability assumed by the Insured under any contract or agreement;

d) to Bodily Injury arising out of the ownership, operation, or the use of any land motor vehicle designed for use principally on public highways, including any machinery or apparatus attached thereto, or any aircraft or watercraft;

e) to Property damage to:

1. Property owned occupied by, or rented to the United States Government or Insured;

2. Property used by the Insured;

3. Property in the care or control of the Insured or as to which the Insured is for any purpose exercising physical control.

f. (1) Bodily Injury, Property Damage, Personal Injury, Advertising Injury or any Administrative Law Proceeding arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants:

(a) At or from any premises, site or location which is or was at any time owned or occupied by, or rented to or loaned to any Insured;

• At or from any premises, site or location which is or was at any time used by or for any Insured or others for handling, storage, disposal, processing or treatment of waste;
• Which are or were at any time transported, handled, stored, treated disposed of, or processed as waste by or for any Insured or any person or organization for whom may be legally responsible; or
• At or from any premises, site or location on which any insured or any contractors or subcontractors working directly or indirectly on any insured’s behalf are performing operations;
• if the pollutants are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor; or
• if the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants

(2) Any loss, cost or expense arising out of any:

• Request, demand or order that any Insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants;

or

• Claim or Suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any wan responding to, or assessing the effects of pollutants.

Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed.

g. (1) Asbestos, asbestos fibers, asbertiform talc or any material and/or substances containing asbestos, asbestos fibers or asbertiform talc or any asbestos related bodily injury, property damage, personal injury, or administrative law proceeding, or exposure to asbestos, asbestos fibers or asbertiform talc in any form, and/or manifestation of any asbestos related bodily injury, including but not limited to asbestosis, mesotheliomia and/or brochogenic carcinoma; or

• Any alleged act, error or omission or duty involving asbestos, asbestos fibers or asbertiform talc or any material and/or substances containing asbestos, asbestos fibers or asbertiform talc its use, exposure, presence, existence, detection, removal, elimination or avoidance; or
• The use, exposure, presence, existence, detection, removal, elimination or avoidance of asbestos, asbestos fibers or asbertiform talc or any material and/or substances containing asbestos, asbestos fibers or asbertiform talc in any environment, building or structure.
• Any procedures, including grievance procedures and arbitration hearings, that are provided by any collective bargaining agreements.

This article offers a brief description of the Professional Liability Insurance plan. Details can be found in the Certificate of Insurance, which will be available to you upon enrollment.

Although every attempt has been made to verify the accuracy of the information contained on this website, errors and omissions may occur. The Certificate of Insurance describing the exact coverage and benefits purchased will be available upon enrollment. This website explains the general purposes of the insurance described, but in no way changes or affects the insurance afforded under the group insurance policy actually issued. All coverage is subject to the actual policy conditions and exclusions.

Professional Liability Insurance

(All forms are in PDF format. If you cannot
print a form, please call 1-800-221-3083
and we will be glad to mail forms to you.)

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