Accident Plan
Support When the Unexpected Occurs
Have you ever dislocated a joint or gotten a deep cut? How about something more severe like a concussion or broken bone?
NCFlex offers an Accident Plan that pays benefits for specific injuries and events resulting from a covered accident on or after your coverage effective date. For most accidents, it can fill the coverage gap left by any State Health Plan out-of-pocket costs you incur. Benefits are paid directly to you and are paid in addition to any other insurance you have.
You can choose between two options on the Accident Plan: Classic or Enhanced. The rates and amounts paid to you for a covered accident differ by option.
How the Accident Plan Helps
The Accident Plan can help you pay for:
- Medical expenses like deductibles and copays
- Home health care costs
- Lost income due to lost time at work
- Everyday expenses like utilities and groceries
You choose who to cover and can include your children, spouse, the whole family or just yourself. The plan also includes a Sports Accident Benefit with an additional payout for injuries sustained while playing an organized sport. Plus, you'll have a Wellness Benefit and Travel Assistance Service.
Available Accident Benefits
A summary of the benefits provided by the Accident Plan and the payouts for each plan option is available for review.
For a complete description of available benefits, exclusions and limitations, see the certificate of insurance and review relevant riders as well.
- Surgery
- Blood, plasma, platelets
- Hospital admission or confinement
- Transportation and lodging
- Medical equipment
- Physical or occupational therapy
- Burns or skin grafts
- Emergency dental work
- Eye injury
- Lacerations/sutures
- Concussion
- Dislocations and fractures
- Wellness Benefit: If you complete an eligible health screening test, you're eligible for a payment.
- Voya Travel Assistance: Covered employees and their covered dependents have access to enhanced security for their leisure and business trips when traveling 100 miles or more from their primary residence.
- Sports Accident Benefit: If a covered accident occurs while participating in an organized sport, some benefits may be increased by 25% to a maximum additional benefit of $1,000.
- Sickness Hospital Confinement Rider (Enhanced Only): This rider provides daily benefit payments for each day a covered employee or covered dependent is confined to a hospital due to a covered event for up to 30 days.
Exclusions and limitations may vary by state. See the certificate of insurance and riders for a complete list of exclusions and limitations.
Benefits are not payable for any loss caused in whole or directly by the following:
- Participation or attempt to participate in a felony or illegal activity
- An accident while the covered person is operating a motorized vehicle while intoxicated. Intoxication means the covered person's blood alcohol content meets or exceeds the legal presumption of intoxication under the laws of the state where the accident occurred.
- Suicide, attempted suicide or any intentionally self-inflicted injury, while sane or insane.
- War or any act of war, whether declared or undeclared, other than acts of terrorism.
- Loss sustained while on active duty as a member of the armed forces of any nation.
- Alcoholism, drug abuse, or misuse of alcohol or taking drugs, other than under the direction of a doctor.
- Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.
- Operating, training to operate, serving as a crew member of, jumping, parachuting or falling from any aircraft or hot air balloon including those which are not motor-driven.
- Engaging in hang-gliding, bungee jumping, parachuting, sail gliding, parasailing, parakiting, kite surfing or any similar activities.
- Practicing for, or participating in, any semi-professional or professional competitive athletic contests for which any type of compensation or remuneration is received.
- Any sickness or declining process caused by sickness.
Monthly Costs
All employees pay the same rate, no matter their age. The option you choose helps determine the benefit amount paid to you.
| Coverage Level | Classic Option | Enhanced Option |
|---|---|---|
| Employee Only | $6.94 | $15.98 |
| Employee and Spouse | $11.50 | $28.46 |
| Employee and Child(ren) | $13.64 | $31.26 |
| Employee and Family | $18.20 | $43.72 |
Need to Know Details
The Accident Plan covers members 24/7 for accidents on or off the job.
The Accident Plan is a limited benefit policy. It is not health insurance and does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. Benefits are paid directly to the employee and are paid in addition to any other insurance they may have.
An employee may not be covered as both an employee and a dependent. Also, dependent children may not be covered under both parents' plans if the employee and their spouse are eligible to elect coverage as employees.
If Voya pays you benefits totaling $600 or more in a plan year, you will receive an IRS 1099-MISC after the plan year ends.
Employees should consult with a tax advisor regarding the possible effects of their taxes.
If you leave employment or retire, portability of the Accident Plan is available if elected before you reach age 70.
For details and rates, contact Voya at 877-464-5111.
Some benefits have a time limit to file, so be sure to file as soon as possible!
The time limit to file a Wellness Benefit is 180 days after the screening is performed or by the end of the plan year (12/31), whichever is later.
| Accident Plan Contact Information | |
|---|---|
| Customer Service | 877-464-5111 Fax claims: 612-467-8721 9 a.m.–5 p.m. (EST), Monday–Friday |
| Mailing Address | LifeHelp Attn: NCFlex 2990 Innsbruck Drive Redding, CA 96003 |
| ncflex@lifehelp.com | |
| Voya Travel Assistance | Anywhere in the world: +1(317)659-5841 Email: assist@imglobal.com Register and Visit Website (How to Register) |
The Accident Plan through Voya became available January 1, 2018. *You may only file claims for accidents or wellness screenings that occur while covered by the Plan. Claims should be filed directly with Voya. Supporting documentation must be included. For questions, contact LifeHelp.