Personal Accident Insurance 

$500,000.00

MAXIMUM COVERAGE LIMITS

ARMY & AIR FORCE EXCHANGE SERVICE

A Voluntary Group Accident Insurance Program With Living Benefits

During this enrollment period and based on your eligibility, you may select up to the maximum shown above.

SUMMARY OF INSURANCE PROVISIONS

The plan offers full 24-hour coverage for accidents incurred while insured and which occur anywhere in the world, on or off the job, on business - on vacation - at home. this material is a guide to the main points of the plan, but it is not the plan itself or a contract or part of one. complete terms and provisions are set forth in the Master Policy. Each participating employee will receive a Certificate of Insurance outlining the details in the Master Policy. The policy is underwritten by General American Life Insurance Company, a member company of The National Accident Insurance Group.

ELIGIBILITY

If you are in one of the following classes of Persons you are eligible to participate in this program:

CLASS

1. All regular full-time, regular part-time active or intermittent (who have completed six (6) months of continuous AAFES service) employees of AAFES who are either a United States citizen, a permanent legal resident alien in the United States or a professional or specialist type employee who is neither a United States citizen nor a legal resident alien in the United States and is engaged in supervisory, administrative or executive duties.
2. All regular active duty military personnel assigned to AAFES.
3. All retired employees of AAFES of former assigned military persons under age 70 who have qualified for immediate retirement benefits under the AAFES or Armed Services Plans.

If you select the Family Plan, your spouse and unmarried children from birth to age 19 are eligible as an insured dependent. children age 19 to 25 will also be insured if attending an accredited school as a full-time student and dependent upon you for support and maintenance. Your own children or adopted children plus any other child who depends on you for support and lives with you in a regular parent-child relationship will also be insured.

Any unmarried dependent child insured under the policy who is incapable of self-sustaining employment because of mental retardation or physical handicap shall continue to be covered beyond the age limit stipulated above according to the terms of the group policy.

In no event may an individual be insured as a dependent of more than one employee, or as both an employee and a dependent.

EFFECTIVE DATE OF COVERAGE

If you are a Class I Employee, coverage will become effective on the first day of the payroll period following validation of your enrollment form by your PEOPLE Resources Office or Headquarters AAFES Insurance and Pension Administration Division.

If you are an eligible Class II or Class III Employee, your coverage will become effective on the date of validation of your enrollment form by the Headquarters AAFES Insurance and Pension administration division.

Once enrolled, Insurance will continue effective until:

1. The date the Master Policy is terminated; or
2. The date you or your dependent no longer meet the eligibility requirements; or
3. The date ending the period for which the last premium payment is made.

SCHEDULED BENEFITS

BENEFIT SCHEDULE - Accidental Death and Dismemberment

When injury causes any of the following losses within 365 days after the date of accident, the plan will pay:

FAMILY PROTECTION PLAN

If you select the Family Plan, your eligible spouse and children are automatically insured for a Principal Sum amount equal to a percentage of the amount chosen for yourself depending on your family status at the time a loss occurs as follows:

1. If you have no children, your eligible spouse is insured for an amount equal to 60 percent of your amount.
2. If you have children, your spouse is insured for an amount equal 50 percent and each eligible child will be insured for an amount equal to 15 percent of your amount.
3. If you have no spouse or your spouse is not eligible, your eligible children are each insured for an amount equal to 20 percent of your amount.

SEATBELT BENEFIT - UP TO $50,000 MAXIMUM

If a covered person accidentally dies as the result of an automobile accident and the person was wearing a seatbelt at the time, an additional 20% of the principal sum up to a maximum of $50,000.00 is paid.

LIVING BENEFITS

HOSPITAL EXPENSE BENEFIT - UP TO $5,000 PER MONTH MAXIMUM

If hospital-confined for more than 7 continuous days due to an accident, within one year of the date of the accident, the plan pays a benefit of 1% of the principal sum benefit up to a maximum of $5,000 per month to the covered person, beginning on the 8th day. The daily benefit will be equal to 1/30th of the monthly benefit.

• It pays in addition to any other medical coverage and is payable for up to 12 months.
• Covers dependents if family plan is selected.

PARALYSIS BENEFIT - UP TO $500,000 MAXIMUM

If an accident causes paralysis of the insured person, within 365 days of the accident, for a period lasting twelve calendar months, and at that time if the insured remains paralyzed, the plan will pay as follows:

Schedule

The term "total paralysis" means an injury to the Spinal Cord of an Insured. The Insured must be paralyzed and under care of a physician for twelve straight months from the date the paralysis began. At the end of this time it must be medically determined that the paralysis is total and not reversible.

• Covers dependents if family plan is selected.

COMATOSE DISABILITY BENEFIT - UP TO $500,000 MAXIMUM

If an accident causes injuries to the Insured person, and within 31 days of the date of injury the Insured is rendered in a state of complete and total unconsciousness for a period of 31 consecutive days, the plan:

• At the end of this time, will pay 2% of the Principal Sum each month for up to 50 months less any other benefits payable elsewhere under the policy. Benefit payments will cease on the earliest of the following: (1) the date the Insured no longer meets the definition of Comatose Disability (2) the date the maximum benefit has been paid or (3) the date of the Insured's Death. If an Insured while receiving this benefit dies before the end of the 50 months, the amount left unpaid will be paid in one sum to the Insured's beneficiary.
• Covers dependents if family plan is selected.

SURVIVOR BENEFITS

DEPENDENT CHILD DAY CARE BENEFIT - UP TO $10,000 MAXIMUM*

If an accident causes injuries to the Insured person or his or her insured spouse, and results in a loss of life for which the plan pays benefits, and his or her "dependent children" were also insured under the policy at the time of the accident, the plan will pay:

• The lesser of the amounts shown in (a) or (b) below, for each insured dependent child who on the date of such loss was enrolled or within 90 days after such loss enrolls in a Day Care Center:

  (a) the actual tuition charged by the Day Care Center; or (b) 2% of the Principal Sum Benefit to a maximum of $2,500 per year.

  Such amount will be paid each year for a total of four consecutive years, but only if the child continues his or her enrollment in the Day Care Center and has not attained age 13 OR:

*ALTERNATE BENEFIT - UP TO $5,000

• If the Insured has dependent coverage but there are no children who qualify for this benefit at the time of the Insured's or spouse's death, the plan will pay to the beneficiary 2% for each insured dependent's child.

CHILDREN'S EDUCATIONAL ASSISTANCE BENEFIT - $20,000 MAXIMUM

If an accident causes injuries to the Insured person and results in a loss of life and his or her spouse and/or "dependent children" were also insured under the policy at the time of the accident, the plan will pay:

• The lesser of the amounts shown in (a) or (b) below, for each insured dependent child (as defined in the policy) who on the date of the accident was enrolled as a full-time student in any institution of higher learning beyond the 12th grade level.

  (a) the actual tuition, exclusive of room and board, charged by such institution per school years; or (b) 5% of the Insured's Principal Sum to a maximum of $5,000 per year for a maximum of four years. Such amount will be paid each year for a total of four consecutive years, but only if the child continues his or her education.

SPOUSE SPECIAL TRAINING BENEFIT - UP TO $5,000 MAXIMUM

If an accident causes injuries to Insured person and results in a loss of life and his or her spouse was also insured under the policy at the time of the accident, the plan will pay:

• The actual tuition incurred by the surviving spouse:

  (a) for any professional or trade training program for which he or she enrolled; and (b) the purpose of which is to obtain an independent source of income; and (c) which is incurred within thirty months of the date of loss. The maximum amount payable is $5,000.

SPECIAL BENEFITS

COMMON ACCIDENT DEATH BENEFIT

If you and your Insured Spouse lose your lives in the same accident, the Plan will pay on behalf of your Insured Spouse an amount of benefits equal to the amount of benefits applicable to you.

DEPENDENT CHILDREN PARALYSIS BENEFIT - UP TO $100,000 MAXIMUM

If an insured dependent child becomes paralyzed, as defined in the policy, the plan will pay four times the principal sum up to a maximum of $100,000.

EXCLUSIONS

The policy does not cover an Insured Person for any loss caused by, contributed to or resulting from:

1. Suicide, while sane or insane (in Missouri, while sane) or intentionally self-inflicted injury;
2. Sickness, disease or bacterial infections of any kind except pyogenic infections which occur through an accidental cut or wound;
3. Injury sustained while, or in consequence of riding as a passenger or otherwise, in:
   1. any aircraft being used for or in connection with acrobatic or stunt flying, racing or endurance tests, crop dusting or seeding or spraying, fire fighting, exploration, pipe or power line inspection, any form of hunting, animal or bird or fowl herding, banner towing or any test or experimental purpose, unless previously consented to in writing by the Company;
   2. injury sustained while, or in consequence of, flying except as a passenger (and not as a member of the crew or while operating or learning to operate) in any aircraft licensed to carry passengers or aircraft operated by Uniformed Military Services of the U.S.A.
   3. coverage is not provided while flying on an aircraft owned or operated by the Policyholder.
4. Injury sustained, directly or indirectly, by the Insured Person's own criminal or felonious act or attempt of such act; or
5. Injury sustained while, or in consequence of riding or driving as a professional in any kind of race for prize money or profit.

If you are interested in enrolling in the Accident Insurance Program please contact the AAFES HQ Benefits Branch at benefits@aafes.com or 1-800-519-3381.

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