The following outline of the AFSA Simplified Issue Term Life Insurance Plan benefits is posted exclusively for AFSA members and their spouses:
- Available to AFSA members and spouses only.
The AFSA Life Plan was designed for AFSA members and their spouses
under age 65 who reside in the U.S., and who are not Confined for medical
care or treatment in an institution or at home - it is not available to the
- Provides up to $200,000.00 in Term Life protection.
With this Plan, you can select the coverage amount you want up to $200,000.00, making it ideal to either: Add to your existing coverage or start a life insurance plan for your loved ones.
- Pays a $1,000.00 cash benefit for Critical Illness.
If you are under age 65 and have a Heart Attack, Stroke or are diagnosed with
Cancer, you would collect a $1,000.00 lump sum cash benefit to use any way
you want - to help pay additional medical expenses or household bills - the
choice is yours!
- Waives your premium if disabled. If an illness or injury makes you Totally Disabled for at least nine consecutive months and your Total Disability starts before you're age 60, your benefits will continue at no cost to you. Your premium will be taken care of for as long as you're Totally Disabled up to age 85.
- Economical group rates.
Thanks to the group purchasing power of AFSA members, your rates are economical. See for yourself:
|Simplified Issue Plan Monthly Group Rates
|Under age 35
|Simplified Issue Plan Monthly Group Rates (Continued)
|Under age 35
- If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a save and secure payment option.
- *No Critical Illness coverage offered for this age bracket. At age 70, your coverage reduces to a maximum of $100,000.
- Your rates are based upon your attained age and increase as you enter each new age category.
- Rates and or/benefits may be changed on a class basis.
- You qualify for nonsmoker rates if you haven’t smoked cigarettes, cigars, or used a pipe or chewing tobacco, nicotine chewing gum or snuff during the 12 months prior to the date you are applying for coverage.
- Rates for members over 60 are for renewal only.
- Effective Date – Your AFSA Life protection will start on the first day of the month after your coverage has been approved and your first premium has been paid. If on the date that you are to become covered under this Policy, you are Confined for medical care or treatment at an institution or at home, coverage will not take effect until the date following your final medical discharge from such confinement.
- MIB Notice – Acceptance into this plan is subject to medical evidence of insurability as determined by Hartford Life and Accident Insurance Company. Depending on your age, the amount of coverage you request, and your answers on the application, a medical examination, medical test(s), or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at your convenience and at no expense to you.
- Termination information – You can keep your AFSA Life coverage up to age 85 – no matter what your health – as long as you remain an AFSA member, pay your premiums on time and the Master Policy stays in force. Coverage for your spouse will continue for as long as he/she remains eligible due to age and marital status.
- Exclusions for the Life Coverage – Benefits paid for death caused by suicide while sane or insane within the first 2 years of the effective date of insurance are limited to a refund of the premiums paid for the insured’s insurance. The two year suicide exclusion, stated above, will also apply if a Covered Person commits suicide during the two years immediately following an increase in coverage under the Policy. In that event, the amount of insurance payable will equal the amount of insurance in force prior to the increase plus an amount equal to the premium paid for the increase to the date of death.
- Exclusions for the Critical Illness Benefit – This benefit will not be payable during the Waiting Period; or if the covered person dies within the 30-day period immediately following a positive diagnosis of a Critical Illness; or if the covered person has already received a Critical Illness benefit; or for a Critical Illness that was positively diagnosed prior to the covered person’s effective date of coverage under this Plan; or for any disease, sickness or injury, except as expressly stated; or for a Critical Illness that is diagnosed by the insured person or any member of his/her immediate family; or for a Critical Illness contracted as a result of war or act of war or service in the armed forces of any country.
- Definitions for Critical Illness means Cancer, Heart Attack, and Stroke – Cancer means the presence of a malignancy characterized by the uncontrolled and abnormal growth and spread of malignant cells in any part of the body. This includes Hodgkin’s disease, leukemia, lymphoma, carcinoma, sarcoma or malignant tumor. It does not include other conditions that may be considered pre-cancerous including, but not limited to: leukoplakia, actinic keratosis, carcinoid, hyperplasia, polycythemia, nonmalignant melanoma, moles, basal cell carcinoma, or similar diseases or lesions. Cancer does not mean carcinoma in situ. Heart Attack means a myocardial infarction only. Heart Attack does not include any other disease, arrhythmia or injury involving the cardiovascular system. Cardiac arrest not caused by myocardial infarction is not a Heart Attack. Stroke means a cerebrovascular accident that results in paralysis lasting more than 24 hours and produces measurable neurological deficit persisting for at least 30 days following the occurrence of the Stroke. Stroke does not mean a head injury, transient ischemic attack or chronic cerebrovascular insufficiency.
- Please Keep For Your Records Notice of Insurance Information Practices – Your application is our major source of information. However, Hartford Life and Accident Insurance Company may also collect or verify information by contacting individuals or organizations that have information or records about you or others to be insured.
Information regarding your insurability will be treated as confidential. Such information will not be disclosed to others without your authorization, except to the extent necessary for the conduct of our business. Hartford Life and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the Medical Information Bureau, a non-profit membership organization of life insurance companies, which operates an information exchange on behalf of its members. If you apply to another Bureau member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, the Bureau, upon request, will supply such company with the information in its file.
|Type of Insurance
||Simplified Issue Term Life Insurance
||Available to AFSA members and spouses only.
||Hartford Life and Accident Insurance Company
|Group Policy Number
| Policy Form Number
||SRP-1153 A (HLA) (1725)
NOTICE OF INSURANCE INFORMATION PRACTICES
To properly underwrite and administer your application for insurance coverage, we must collect certain information concerning your insurability. You are our most important source of information, but we may also contact other sources such as medical professionals and institutions, employers and other insurance companies. While all information regarding your insurability will be treated as confidential, in some situations, and in compliance with applicable law, we may disclose necessary items of information to third parties without your specific authorization.
INVESTIGATIVE CONSUMER REPORTS – NOT APPLICABLE TO RESIDENTS OF NEW YORK
As part of our procedure for processing your application, an investigative consumer report may be prepared by an outside insurance reporting organization. Personal information may be collected from others regarding your general reputation and lifestyle. If an interview is conducted with someone other than you, we will inform you of your right to be interviewed in connection with the preparation of the investigative consumer report. You have the right to send a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.
PERSONAL HISTORY INTERVIEW
To provide you, our client, with the best possible service, we may also conduct what we call a personal history interview. This is a phone call placed from our underwriting office. Its purpose is to make sure that the application information is complete. Our interviewers are trained to conduct their calls in a friendly, professional manner. The nature of the information discussed is always treated as personal and confidential and will only be used to assess your eligibility for insurance.
MEDICAL INFORMATION BUREAU (MIB) PRE-NOTICE
Information regarding your insurability will be treated as confidential. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the MIB, Inc., formerly known as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, MIB, upon request, will supply such company, with the information about you in its file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at (866) 692-6901 (TTY (866) 346-3642). If you question the accuracy of the information in MIB's file, you may contact MIB and seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of MIB's information office is 50 Braintree Hill Park, Suite 400, Braintree, Massachusetts 02184-8734. Hartford Life Insurance Company, Hartford Life and Accident Insurance Company , or their reinsurers, may also release information from their files to other insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Information for consumers about MIB may be obtained on its website at www.mib.com.
ACCESS, CORRECTION AND DISCLOSURE
You can obtain access to personal information about you contained in our policy files by sending us a written request. You may also request any necessary corrections, amendments or deletion of any information in our files which you believe to be inaccurate or irrelevant. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may release information in their files to other life insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Also, please be advised that personal and confidential information collected by us may, in certain circumstances, be disclosed to third parties without authorization. A notice providing further description of the circumstances under which information about you may be disclosed and the types of persons and organizations to whom it may be disclosed will be sent to you upon your written request. If you desire further information or access to your personal information, please send your written request to: Hartford Life Insurance Company or Hartford Life and Accident Insurance Company, 200 Hopmeadow Street, Simsbury, CT 06089.
Hearing-impaired or voice-impaired members may call the Relay Line at  800-855-2881. This Plan is administered by Mercer Consumer, a service of Mercer Health & Benefits Administration LLC.
This website explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.
This is private insurance. This is not associated with SGLI.