What is Accident Insurance?
If you suffer an accidental injury, this plan:
- Pays lump-sum for covered injuries and expenses,
- Covers more than 50 types of injuries, services, and treatments,
- Covers accidents that occur on or off the job,
- Pays you for covered accidental injuries and their treatment, and
- Helps with out-of-pocket costs that your medical plan doesn’t cover, like co-pays and deductibles.
Who is Eligible?
- Be an Active HSTA Member and working a minimum of 17.5 hours per week, or
- Be an Associate HSTA Member regularly employed by the State of Hawaii and working a minimum of 17.5 hours per week, or
- Be a regularly scheduled employee of the Hawaii State Teachers Association and working a minimum of 17.5 hours per week.
Dependent Coverage
As long as you are enrolled for coverage under the Accident Insurance Plan, your family members may also apply for coverage. Eligible family members are your legal spouse and unmarried children under 19 years of age.
See full dependent coverage description on page 31 of Summary Plan Description.
Remember: If you enroll, the $5 benefit subsidy
will be applied to your monthly
| Medium/Platinum | Low/Gold Plan | |
|---|---|---|
| Employee Only | $15.25 | $10.68 |
| Employee + Spouse | $24.66 | $17.35 |
| Employee + Child | $28.47 | $18.75 |
| Employee + Family | $37.88 | $25.42 |
Forms
- ENROLLMENT FORM
- DEPENDENT INFORMATION SHEET
How to File a Claim
If an accident occurs, you must fill out an Accident Claim Form and send it to UNUM. Claim forms are available from the Trust Office. You must send UNUM the claim form not later than 90 days after the accident or as soon as it is reasonably possible to do so, but in no event more than one year after the time this proof is required.
Send the completed Accident Claim Form by mail or fax to:
The Benefits Center
P.O. Box 100158
Columbia, SC, 29202-3158
Toll free Fax: 1-800-447-2498
Toll free number: 1-800-635-5597
For assistance call toll free Monday through Friday, 8:00 a.m. to 8:00 p.m. (Eastern Standard Time)