Accident Insurance

Examples: Select an amount of coverage
that best suits your needs:
Employee Spouse Each Child
Plan A - Employee only (100%)

$100,000

Plan B - Employee (100%) and Spouse (50%)

$100,000

$50,000

Plan C - Employee (100%) and Spouse (100%)

$100,000

$100,000

Plan D - Employee (100%) and Child (10%)

$100,000

$10,000

Plan E - Employee (100%), Spouse (50%),
and Child (10%)

$100,000

$50,000

$10,000

Plan F - Employee (100%), Spouse (100%),
and Child (10%)

$100,000

$100,000

$10,000


Refer to the chart below for pre-calculated monthly premiums.

Rate per
thousand

$25,000

$50,000

$75,000

$100,000

$125,000

$150,000

0.035

Plan A

$0.88

$1.75

$2.63

$3.50

$4.38

$5.25

0.051

Plan B

$1.28

$2.55

$3.83

$5.10

$6.38

$7.65

0.067

Plan C

$1.68

$3.35

$5.03

$6.70

$8.38

$10.05

0.041

Plan D

$1.03

$2.05

$3.08

$4.10

$5.13

$6.15

0.057

Plan E

$1.43

$2.85

$4.28

$5.70

$7.13

$8.55

0.073

Plan F

$1.83

$3.65

$5.48

$7.30

$9.13

$10.95


Rate per
thousand

$175,000

$200,000

$225,000

$250,000

$275,000

$300,000

0.035

Plan A

$6.13

$7.00

$7.88

$8.75

$9.63

$10.50

0.051

Plan B

$8.93

$10.20

$11.48

$12.75

$14.03

$15.30

0.067

Plan C

$11.73

$13.40

$15.08

$16.75

$18.43

$20.10

0.041

Plan D

$7.18

$8.20

$9.23

$10.25

$11.28

$12.30

0.057

Plan E

$9.98

$11.40

$12.83

$14.25

$15.68

$17.10

0.073

Plan F

$12.78

$14.60

$16.43

$18.25

$20.08

$21.90


The VAI policy does not cover loss due to suicide or attempted suicide, or intentionally self-inflicted injury, while sane or insane; or illness, disease, pregnancy, childbirth, miscarriage, or bodily or mental infirmity; or any medical or surgical treatment or diagnosis therefor; or ptomaines, bacterial infection, or any other infection (except pyogenic infection which shall occur through or with an external cut or wound sustained through external, violent, and accidental means); or war or insurrection', whether declared or undeclared, or any incident attributable thereto, or any act of war, or any hostile action by a foreign power, whether or not the Insured is in any armed forces; or accidental bodily injury occurring while the Insured is serving on active duty in the Armed Forces of any country or international authority; or travel or flight in any vehicle or device of aerial navigation, including boarding or alighting therefrom, while being used for any test or experimental purpose; or while traveling or flying in any aircraft as a member of the crew thereof; or while engaged in skydiving, crop dusting, banner towing, glider or parasailing or other aerial devices or experimental test flights; or while engaged in learning to fly an aircraft; or any loss occurring while attempting or engaging in any felonious activity.


MEDICAL UNDERWRITING:

Should you decline to enroll at the time you first become eligible and decide to enroll at a later date, acceptance will be subject to evidence of insurability requirements submitted to Dearborn National Insurance Company (DNIC).Your coverage will not become effective until approved by DNIC.

Should you elect to increase the amount of coverage after your coverage is in force, acceptance of the additional amount of coverage will be subject to evidence of insurability requirements submitted to DNIC. Your coverage will not become effective until approved by DNIC.


This enrollment package is for illustrative purposes only and does not constitute a contract. The full terms and conditions of the coverages you select will be contained in the policies issued to Baylor University.