Membership Plans from United Business Association

UBA MEMBERSHIP

MEMBER DRIVEN VALUE.

Unlock the value of your UBA Membership.

Your membership in the United Business Association (UBA) gives you access to lifestyle and business benefits and services like lab discounts, 24-hr emergency roadside assistance, office supply discounts, and access to enroll in association group insurance programs. UBA Membership is an excellent fit for small business owners, employees, and their families. Your membership in UBA offers you Member Driven Value, and We are Better Together. Join UBA as a stand-alone membership or add additional products to enhance your membership like the Non-Insurance Subscription Benefit Boost Family of Products or the optional supplemental UBA Gap Products that include group insurance. Become a member of United Business Association and start leveraging your purchasing power with other members today!

UBA Membership State Availability
All 50 U.S. States

This Monthly Association Membership includes
Non-Insurance Services Only

Product Cost^*

$10 for the entire family
Brief Association Membership Description
UBA MEMBERSHIP

Unlock the value of your UBA Membership.

Business Services of UBA Membership
- Car Rental Discount
- TrueCar Buying Network
- Graduate Scholarship Program
- LuckyDiem
- 24-Hr Roadside Assistance
- TravNow
- 1800Flowers.com Discounts
- ADP Payroll Processing Service
- Office Max Offices Supplies & Furniture Discounts
- Hewlett (HP) Computers & Equipment
- UPS Express Delivery Service
- LegalConnect^®
- Choice Hotels Discounts
- Apply for Business Insurance: Business Owner's Policy
- Apply for Business Insurance: Data Breach & Cyber Liability
- NEW (09/02/21): TruPoint Tax Service
- NEW (09/02/21): Constant Contact Email Marketing
Lifestyle Services of UBA Membership
- 24-Hr Nurse Helpline
- Health Savings Account with HSA Bank^®
- Lab Discounts
- Gateway Medicard
- VSP Individual Savings Pass
- Discount Hearing Service
- Travel Assistance Plan
- GymAmerica.com
- Child ID Card Services
- National Theme Park Discounts
- Tickets at Work
- Savings Perks Program
- NEW (09/02/21): Safelite Autoglass
- NEW (09/02/21): Discounts on Spot Pet Health Insurance
Networking with UBA

Advertise your Small Business for FREE and network with other UBA Members. Don't have an ad? That's okay! UBA can create one for you.

Optional Group Supplemental Insurance

Access to enroll in association group insurance programs like group accident insurance, group hospital fixed indemnity insurance, group term life insurance, critical illness insurance, and more...

THIS IS AN ASSOCIATION MEMBERSHIP.

Read the brochure carefully. This is a brief description of the membership services available to you in the United Business Association membership. Product features, additional products, and availability may vary by state. While we believe you will be pleased with your overall association membership, we cannot, however, warrant or guarantee the performance of any discount or service. You must be a member of the United Business Association in order to purchase any product that includes group association insurance issued to the United Business Association. Services and product cost are subject to change.

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Non-Insurance UBA Membership Benefit Details

VIEW UNITED BUSINESS ASSOCIATION

MEMBERSHIP DETAILS & SERVICES
Get a Quote & Apply

GET QUOTE & APPLY

BENEFIT BOOST

IMPROVING HEALTH.

A strategy to boost your overall health.

The Benefit Boost Monthly Subscription offers highly regarded services for those looking to seek immediate Virtual Urgent Care Medical Visits or Virtual Talk Therapy when you are sick or feeling down, for members looking to save on medications at the pharmacy for you or your pets, or to keep a healthy lifestyle with free vitamins, dental discounts, and protection against identity theft. Benefit Boost is a non-insurance strategy to boost your overall health. Purchase Benefit Boost Subscription as a stand-alone product, or it is available as part of most of the UBA Gap Products that include group insurance (check UBA products for availability). This optional Non-Insurance Subscription Product helps to enhance and add more value to your membership in the United Business Association.

Benefit Boost State Availability
All 50 U.S. States

This Monthly Subscription Membership includes
Non-Insurance Services Only

Product Cost^*

$25 - Ind | $40 - Ind+1 | $60 - Family
Brief Membership Description

BENEFIT BOOST SUBSCRIPTION

A strategy to boost your overall health.

Telehealth Service with MeMD^®

$0.00 Cost^* to all Members

URGENT CARE TELEHEALTH

Ideal for common illnesses and minor injuries like allergies, flu symptoms, sinus symptoms, UTIs and more.

TALK THERAPY TELEHEALTH

MeMD's national provider network of licensed professional counselors, clinical social workers, marriage and family therapists are there to help with common teletherapy issues like abuse, addiction, anxiety, stress and more.

^*Visits are paid by Healthy America and not by member.

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution services with MeMD^®.

Free Gummy Multi-Vitamins

High quality multi-vitamins that come in strawberry and cherry gumdrops. They are free to all Members including shipping and come in a 90-day supply.

Retail RX & Pet RX Discounts

Save on prescriptions at a participating retail pharmacy and also save on your pet medications with your Retail RX and Pet RX Discounts cards. Use the web tool to locate a participating pharmacy, get your discounted pharmacy pricing and research your drug and cost-effective alternatives.

Dental Discounts with Aetna Dental Access^® Network

Members can save 15% to 50%^* per visit, in most instances, on services at any of the many available dental practice locations nationwide. Dental services include: cleanings, x-rays, fillings, root canals, and crowns. Members can also save on specialty care such as orthodontics and periodontics where available.

^*Actual costs and savings vary by provider, service and geographical area.

Identity Theft Protection with LifeLock^®

Help protect your identity in our digitally-connect world. As a member, you can get over 20% off your first year of LifeLock membership^*.

^*Terms apply. Designated trademarks and brands are the properties of their respective owners.

THIS IS A MONTHLY SUBSCRIPTION MEMBERSHIP AND IS NOT INSURANCE.

Read the brochure carefully. This is a brief description of the membership services available to you in the Benefit Boost membership subscription. Product features and availability may vary by state. While we believe you will be pleased with your overall association membership, we cannot, however, warrant or guarantee the performance of any discount or service. Services and product cost are subject to change. These Benefit Boost services are included in any of the optional UBA Supplemental Gap Products that include insurance (except Gap AME 10K, UBA Dental, UBA Vision & STM Products).

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Non-Insurance Benefit Boost Subscription Service Details

VIEW BENEFIT BOOST SERVICE

MEMBERSHIP DETAILS
Get a Quote & Apply

GET QUOTE & APPLY

VIRTUAL PCP SOLUTION
WITH MeMD^®

VIRTUAL PRIMARY CARE.

Primary care for the modern world.

The Virtual PCP Solution Subscription Non-Insurance Product through MeMD^® offers members virtual primary care benefits all year for about the cost of one routine in-person visit along with virtual urgent care visits & talk therapy, lab work & imaging, ongoing chronic care management, & continuity of care. Virtual PCP Solution is a non-insurance strategy to help members save money on routine healthcare costs. Purchase it stand-alone or with other UBA Products. Virtual PCP Solution with MeMD is in the family of Benefit Boost Subscription Products. This optional Non-Insurance Subscription Product helps to enhance and add more value to your membership in the United Business Association.

Virtual PCP Solution with MeMD^®
State Availability
All 50 U.S. States

This Monthly Subscription Membership includes
Non-Insurance Services Only

Product Cost^*

$30 - Ind | $60 - Ind+1 | $60 - Family
Brief Membership Description

VIRTUAL PCP SOLUTION
WITH MeMD^®

Primary care for the modern world.

VIRTUAL PRIMARY CARE VISITS WITHIN 24 HRS

$0.00 Visit Fee^* to all Members

Get preventive, ongoing and situational care you need without the financial stress with MeMD's virtual care primary visits within 24 hours. The average wait time for an initial in-person appointment is 24 days. MeMD's Virtual Primary Care Solution gives members access to their chosen PCP within as little as 24 hours.

CHOOSE YOUR PROVIDER

Members are able to select a MeMD virtual care provider from a team of providers licensed in their state. When choosing a provider, members can review a detailed bio that includes the provider's certification, experience and other relevant information.

^*$0 virtual primary care visit capped at five per individual, per month. Each virtual primary care visit above the cap will be charged at MeMD's then-current standard primary care visit fee rate, which will be collected at the time of service.

Virtual Urgent Care & Talk Therapy Visits

$0.00 Visit Fee^* to all Members

VIRTUAL URGENT CARE VISITS

Ideal for common illnesses and minor injuries like allergies, flu symptoms, sinus symptoms, UTIs and more.

VIRTUAL TALK THERAPY VISITS

MeMD's national provider network of licensed professional counselors, clinical social workers, marriage and family therapists are there to help with common teletherapy issues like abuse, addiction, anxiety, stress and more.

^*$0 therapy visits are capped at five per individual, per month. Each therapy visit above the cap will be charged at MeMD's then-current standard therapy visit fee rate, which will be collected at the time of service.

Note: If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution services with MeMD^®.

Lab Work & Imaging with Virtual PCP Solution

VIRTUAL WELLNESS

Through partnerships with Quest, LabCorp, Green Imaging, and more, members have access to labs and imaging that can be paid for through insurance or with cash. Virtual Wellness Visits are available to members once every 12 months at no cost.

WELLNESS LABS INCLUDED

Six labs are included in the wellness visit, such as complete metabolic panel or clinical urine tests, when using Quest or LabCorp when ordered by the PCP.

Ongoing Chronic Care Management

MeMD's Virtual Primary Care Solution allows members to receive ongoing treatment and medication^* for a wide range of chronic conditions including diabetes, asthma, arthritis, anxiety, COPD, and high blood pressure.

^*When medically necessary, MeMD's providers (except therapists) can submit a prescription electronically for purchase and pick-up at your local participating pharmacy; however, MeMD providers cannot prescribe elective medications, narcotic pain relievers, or controlled substances. MeMD's providers are each licensed by the appropriate licensing board for the state in which they are providing services, and all have prescriptive authority for each of the states in which they are licensed.

Continuity of Care

Continuity of care is essential for improving health outcomes and lowering overall healthcare costs. With easy access to a dedicated virtual primary care provider, a care team that is available 24/7, and an orientation around holistic care, members can get the care and direction they need for their ongoing health.

1:1 Care Navigation Team

Professional and compassionate care navigators are available for a call or chat to help members sign up, coordinate medical care, facilitate intelligent referrals and in-person care, and answer administrative questions - giving members the personal attention they want and need.

Retail Prescription Discounts with Paramount RX

Save on prescriptions at a participating retail pharmacy with the Retail Prescription Discounts card. Use the web tool to locate a participating pharmacy, get your discounted pharmacy pricing and research your drug and cost-effective alternatives.

THIS IS A MONTHLY SUBSCRIPTION MEMBERSHIP AND IS NOT INSURANCE.

Read the brochure carefully. This is a brief description of the membership services available to you in the Virtual PCP Solution with MeMD membership. Product features and availability may vary by state. While we believe you will be pleased with your overall association membership, we cannot, however, warrant or guarantee the performance of any discount or service. Services and product cost are subject to change.

MeMD^® provides access to online medical consultations with physicians, nurse practitioners, and physician assistants who can write prescriptions when medically necessary and permitted by state law. MeMD also provides access to online counseling or talk therapy with behavioral health providers; however, therapists cannot write prescriptions. MeMD is not an online pharmacy, and medications cannot be purchased or dispensed from MeMD directly. The MeMD service is not a replacement for your primary care physician or annual office check-ups, nor is it a replacement for other treating providers (except in the context of mental and behavioral health services or in the Virtual Primary Care service line where the Provider has explicitly agreed to assume such a role). Subject to state regulations, MeMD is available nationwide with providers licensed to practice in your state who use video and/or audio technology.

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Non-Insurance Benefit Virtual PCP Details

VIEW VIRTUAL PCP SOLUTION

MEMBERSHIP DETAILS
Get a Quote & Apply

GET QUOTE & APPLY

COMPLEMENT CARE

TAKE CARE OF YOURSELF.

Complement traditional health insurance
with ER & Dr visits.

Complement your UBA Membership with the Complement Care Product which offers valuable coverage for those that want that extra layer of protection for some out-of-pocket costs for physician office visits, urgent care center visits, or emergency room visits. Complement are helps you get the care you need when you need it. Take care of yourself and complement your traditional health insurance with Complement Care. Complement Care is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association.

Complement Care
State Availability
AL, AR, AZ, CA, CO, FL, GA, IL, IN, MI, NC, NE, NJ, NV, OK, TX, & WI

This Optional Product includes
Group Insurance Only

Product Cost^*

$35 - Ind | $70 - Ind+1 | $120 - Family
Brief Group Insurance Description

COMPLEMENT CARE

Complement traditional health insurance
with ER & Dr visits.

Group Hospital Indemnity Insurance

Physician Visit and Urgent Care Visit Benefit

$125 per visit up to 4 visits per Covered Person per Coverage Year.

We will pay a daily benefit for each visit made by a Covered Person to a Physician's Office or a licensed Urgent Care Facility to receive care or treatment of a Sickness, an Accident or an Injury.

Member and Dependent coverage ends when the Member is age 65.

Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company.

Group Hospital Indemnity Insurance

Emergency Room Visit Benefit

$500 per visit up to 2 visits per Covered Person per Coverage Year.

We will pay a daily benefit for a Physician's treatment of a Covered Person during an Emergency Room visit during which Emergency Care is provided for Sickness, Accident or Injury.

Member and Dependent coverage ends when the Member is age 65.

Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company.

Group Hospital Indemnity Insurance

Pre-existing Condition Limitation

We will not cover any loss due to a Pre-existing Condition if the loss begins within 12 months after the Covered Person's effective date of insurance. However, we may pay benefits for a loss due to a Pre-existing Condition of a Covered Person who was covered:

1. by a Replaced Policy; and
2. by the Policy, issued by Us to the Policyholder on the Policy Effective Date, and this Certificate.

We will review the claim. If the Pre-Existing Condition Limitation in this Certificate does not apply, We will pay the benefits provided by the Policy and this Certificate.

If the Covered Person does not satisfy this Certificate's Pre-existing Condition Limitation, but can satisfy the Replaced Policy's pre-existing condition limitation giving credit for all time insured under both policies; then We will pay the lesser of:

1. the benefits provided by the Policy and this Certificate without applying the Pre-existing Condition Exclusion; or
2. the benefits provided by the Replaced Policy.

If the Covered Person does not satisfy this Certificate's Pre-existing Condition Limitation or that of the Replaced Policy, no Benefit will be paid.

Definition of Pre-existing Condition:

Pre-existing condition means a condition for which a Physician has treated or for which a Physician has advised treatment of the Covered Person within 12 months before the Covered person's effective date of insurance.

Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company.

Group Hospital Indemnity Insurance

Coverage Year:

Means a period beginning on the Primary Covered Person's Certificate Effective Date and ending 12 months after that date. Successive Coverage Years will begin after the first Coverage Year, each extending for 12-Month periods, provided that the Primary Covered Person does not terminate His coverage within the same Coverage Year. If the Primary Covered Person terminates His coverage during a Coverage Year and re-enrolls for coverage under a new certificate within the same Coverage Year, all benefits, benefit limits and benefit maximums will be those that applied to Him under the previously terminated certificate. In this case, a new Coverage Year will begin for the Primary Covered Person after He has been insured under the new certificate of a period of 12 months.

Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP HOSPITAL INDEMNITY INSURANCE

UNDERWRITTEN BY:
Sirius America Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. COVERAGE IS PROVIDED UNDER GROUP HOSPITAL INDEMNITY INSURANCE ONLY POLICIES.

The following monthly insurance rates apply to coverage underwritten by Sirius America Insurance Company¹. Your overall total association membership dues for the optional supplemental Complement Care Product also include these monthly insurance rates:

¹Group Hospital Indemnity Insurance:
$10.85 (Individual), $23.44 (Ind+1), $36.73 (Family)

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Hospital Indemnity Insurance is underwritten by Sirius America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Member and Dependent Coverage ends when the Member is age 65. We will provide coverage for the benefits and services shown in the Schedule of Benefits that are required for the Medically Necessary treatment of a Covered Person's Injury or Sickness while insurance under the Policy is in force, subject to all applicable terms, conditions, provisions and exclusions. Hospital Indemnity Benefits will be paid until any applicable Daily Benefit Amount or other benefit limit shown in the Schedule of Benefits has been reached; until the total of a Covered Benefit or Service equals any applicable Maximum Number of Daily Benefits, Lump Sum Benefit Amount, Maximum Number of Payments or Coverage Year Maximum shown in the Schedule of Benefits. Product cost for the Complement Care Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Sirius America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

HASA-HI-1000

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
  - Arizona
  - Arkansas
  - California
  - Colorado
  - Florida
  - Georgia
  - Illinois
  - Indiana
  - Michigan
  - Nebraska
  - Nevada
  - New Jersey
  - North Carolina
  - Oklahoma
  - Texas
  - Wisconsin
Claim Forms

GET HOSPITAL INDEMNITY CLAIM FORM
Get a Quote & Apply

GET QUOTE & APPLY

GAP AME 10K

ACCIDENTS HAPPEN.

Life is unpredictable and sometimes we get hurt.

The Gap AME 10K Product provides exceptional protection against accidents and accidental death & dismemberment. This product is a group accident only insurance product. The Gap AME 10K Product is valuable coverage for young families, people who tend to be accident-prone, or those that want that extra layer of protection for some of their out-of-pocket medical costs due to an accident. The Gap AME 10K Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association.

Gap AME 10K State Availability
Underwritten by Guaranteed Trust Life Insurance Company (GTL)
AL, AZ, AR, CA, CT, DC, DE, FL, GA, IL, IN, IA, KS, KY, MI, MS, NC, ND, NE, NJ, NV, OH, OK, PA, RI, SC, TN, TX, VA, WV, WI & WY

This Optional Product includes
Group Insurance Only

Product Cost^*

$25 - Ind | $50 - Ind+1 | $60 - Family
Brief Group Insurance Description
GAP AME 10K

Life is unpredictable and sometimes we get hurt.

Group Accident Only Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Benefit Maximum Benefit per injury.

$100 Deductible per injury.

Covered Services (as defined by policy) & Maximum Benefit:
- We pay up to the Policy Limits - Hospital Room & Board, general nursing care, up to the semi-private room rate.
- We pay up to the Policy Limits - Hospital miscellaneous expenses during the hospital confinement or for outpatient surgery under general anesthetic, such as the cost of the operating room, laboratory tests, x-ray exams, anesthesia, drugs (excluding take-home drugs), or medicines, therapeutic services and supplies.
- We pay $1,000 - Doctor's fees for surgery.
- We pay $250 - Anesthesia services.
- We pay $75 - Doctor's visits per visit (inpatient & outpatient).
- We pay $500 - Hospital Emergency care.
- We pay $250 - X-ray and Laboratory service.
- We pay $250 - Ambulance expense.
- We pay up to the Policy Limits - Prescription drug coverage.
- We pay $250 - Dental treatment for injury to sound natural teeth per tooth.
- We pay up to the Policy Limits - Registered nurse expense.
- We pay $20 - Chiropractic per visit.
- We pay $25 - Physical therapy per visit.
- We pay $50 - Durable medical equipment.
Group Accident Insurance is underwritten by Guarantee Trust Life Insurance Company (GTL).

Group Accident Only Insurance

Group Accidental Death & Dismemberment Insurance

$1,000 Accidental Death & Dismemberment Benefit Principal Sum

Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE ONLY INSURANCE
UNDERWRITTEN BY:
Guarantee Trust Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS GROUP ACCIDENT ONLY INSURANCE.

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Guarantee Trust Life Insurance Company (GTL) provides the Accident Medical Expense benefit and the Accidental Death & Dismemberment benefit. GTL does not provide nor is affiliated with the discount programs provided as part of membership in the United Business Association. The insurance described in this document provides limited benefits. Limited benefit policies are insurance products intended to help supplement comprehensive health insurance plans. This insurance is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, this insurance is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Product Cost does not include the separate $10 UBA Membership dues. Product cost does include Association information, awareness benefits, consumer savings, service programs, insurance rates (of $7.75 for Ind, $19.37 for Family), marketing and administrative cost. You must be a member of the United Business Association in order to purchase this product.

Guarantee Trust Life Insurance Company, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AAD101.15-19

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
Claim Forms

GET ACCIDENTAL DEATH CLAIM FORM

GET ACCIDENTAL DISMEMBERMENT

& LOSS OF SIGHT CLAIM FORM

GET ACCIDENT MEDICAL EXPENSE CLAIM FORM
Get a Quote & Apply

GET QUOTE & APPLY

GAP AME 10K

ACCIDENTS HAPPEN.

Life is unpredictable and sometimes we get hurt.

If you are looking for simple Accident Only Coverage with the added benefits of Benefit Boost, the Gap AME 10K + Benefit Boost Product might be the right product to add to your UBA Membership. Give a boost to your UBA Membership with the Gap AME 10K + Benefit Boost Product which offers valuable coverage for families, people who tend to be accident-prone or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident or injury along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Gap AME 10K + Benefit Boost Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association.

Gap AME 10K + Benefit Boost
State Availability
Underwritten by Guaranteed Trust Life Insurance Company (GTL)
AL, AZ, AR, CA, CT, DC, DE, FL, GA, IL, IN, IA, KS, KY, MI, MS, NC, ND, NE, NJ, NV, OH, OK, PA, RI, SC, TN, TX, VA, WV, WI & WY

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$50 - Ind | $90 - Ind+1 | $120 - Family
Brief Group Insurance Description
GAP AME 10K BOOST

Life is unpredictable and sometimes we get hurt.

Group Accident Only Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Benefit Maximum Benefit per injury.

$100 Deductible per injury.

Covered Services (as defined by policy) & Maximum Benefit:
- We pay up to the Policy Limits - Hospital Room & Board, general nursing care, up to the semi-private room rate.
- We pay up to the Policy Limits - Hospital miscellaneous expenses during the hospital confinement or for outpatient surgery under general anesthetic, such as the cost of the operating room, laboratory tests, x-ray exams, anesthesia, drugs (excluding take-home drugs), or medicines, therapeutic services and supplies.
- We pay $1,000 - Doctor's fees for surgery.
- We pay $250 - Anesthesia services.
- We pay $75 - Doctor's visits per visit (inpatient & outpatient).
- We pay $500 - Hospital Emergency care.
- We pay $250 - X-ray and Laboratory service.
- We pay $250 - Ambulance expense.
- We pay up to the Policy Limits - Prescription drug coverage.
- We pay $250 - Dental treatment for injury to sound natural teeth per tooth.
- We pay up to the Policy Limits - Registered nurse expense.
- We pay $20 - Chiropractic per visit.
- We pay $25 - Physical therapy per visit.
- We pay $50 - Durable medical equipment.
Group Accident Insurance is underwritten by Guarantee Trust Life Insurance Company (GTL).

Group Accident Only Insurance

Group Accidental Death & Dismemberment Insurance

$1,000 Accidental Death & Dismemberment Benefit Principal Sum

Group Accident Only Insurance is underwritten by Guarantee Trust Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE ONLY INSURANCE
UNDERWRITTEN BY:
Guarantee Trust Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS GROUP ACCIDENT ONLY INSURANCE.

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Guarantee Trust Life Insurance Company (GTL) provides the Accident Medical Expense benefit and the Accidental Death & Dismemberment benefit. GTL does not provide nor is affiliated with the discount programs provided as part of membership in the United Business Association. The insurance described in this document provides limited benefits. Limited benefit policies are insurance products intended to help supplement comprehensive health insurance plans. This insurance is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, this insurance is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Product Cost does not include the separate $10 UBA Membership dues. Product cost does include Association information, awareness benefits, consumer savings, service programs, insurance rates (of $7.75 for Ind, $19.37 for Family), marketing and administrative cost. You must be a member of the United Business Association in order to purchase this product.

Guarantee Trust Life Insurance Company, United Business Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AAD101.15-19

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
Claim Forms

GET ACCIDENTAL DEATH CLAIM FORM

GET ACCIDENTAL DISMEMBERMENT

& LOSS OF SIGHT CLAIM FORM

GET ACCIDENT MEDICAL EXPENSE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Gap AME 10K + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Sirius America Insurance Company and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Gap Basic Product)
Get a Quote & Apply

GET QUOTE & APPLY

GAP BASIC

GAP YOUR DEDUCTIBLE.

Don't break the bank for out-of-pocket expenses.

This simply designed and easy to understand product is one of UBA's more affordable optional product options. Give a boost to your UBA Membership with the Gap Basic + Benefit Boost Product which offers valuable coverage for young families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident or being diagnosed with a Critical Illness along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Gap Basic + Benefit Boost is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association.

Gap Basic + Benefit Boost
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$30 - Ind | $50 - Ind+1 | $70 - Family
Brief Group Insurance Description

GAP BASIC BOOST

Don't break the bank for out-of-pocket expenses.

Blanket Group Accident Insurance

Blanket Group Accident Medical Expense Insurance

$5,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Blanket Group Accidental Death & Dismemberment Insurance

$2,500 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Blanket Group Accident Insurance is underwritten by Sirius America Insurance Company.

Group Critical Illness Insurance

Critical Illness Insurance Benefit

$5,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $1000 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Sirius America Insurance Company.

Group Term Life Insurance

$5,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, CO, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

BLANKET GROUP ACCIDENT INSURANCE
& GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
Sirius America Insurance Company

GROUP TERM LIFE INSURANCE
UNDERWRITTEN BY:
Investors Heritage Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. COVERAGE IS PROVIDED UNDER BLANKET ACCIDENT, GROUP CRITICAL ILLNESS AND GROUP TERM LIFE INSURANCE ONLY POLICIES.

The following monthly insurance rates apply to coverage underwritten by Sirius America Insurance Company¹ and Investors Heritage Life Insurance Company². Your overall total association membership dues for the optional supplemental Gap Basic + Benefit Boost Product also include these monthly insurance rates:

¹Blanket Group Accident Insurance:
$4.17 (Individual), $8.37 (Ind+1), $15.76 (Family)

¹Group Critical Illness Insurance:
$3.26 (Individual), $6.51 (Ind+1), $6.51 (Family)

²Group Term Life Insurance:
$1.90 (Individual), $3.80 (Ind+1), $3.80 (Family) - in available states

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Accident Insurance and Group Critical Illness Insurance are underwritten by Sirius America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Group Critical Illness Insurance Benefit Maximum is reduced if the first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and covers member and eligible spouse only and coverage ends at age 65. Product cost for the Gap Basic Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Sirius America Insurance Company, Investors Heritage Life Insurance Company and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

HASA-1000 | HASA-BAM-1000

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
  - Arizona
  - Arkansas
  - California
  - Colorado
  - Delaware
  - District of Columbia
  - Florida
  - Georgia
  - Illinois
  - Indiana
  - Kansas
  - Kentucky
  - Louisiana
  - Michigan
  - Mississippi
  - Missouri
  - Nebraska
  - Nevada
  - New Jersey
  - North Carolina
  - North Dakota
  - Ohio
  - Oklahoma
  - Rhode Island
  - Tennessee
  - Texas
  - Virginia
  - West Virginia
  - Wisconsin
  - Wyoming
Claim Forms

GET ACCIDENT CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM

Term Life States are:
AL, AR, AZ, CA, CO, FL, GA, IL, IN, KY, MI,
MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA
GET TERM LIFE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Gap Basic + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Sirius America Insurance Company and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Gap Basic Product)
Get a Quote & Apply

GET QUOTE & APPLY

GAP PLUS

BRIDGING THE GAP.

Unexpected out-of-pocket expenses happen.

The Gap Plus + Benefit Boost Product offers the same superior protection as our Gap Basic + Benefit Boost Product but with additional Group Hospital Fixed Indemnity Insurance benefits for daily hospital confinement, daily physician office visits, daily outpatient diagnostic laboratory tests, and daily outpatient diagnostic radiology & x-rays. Give a boost to your UBA Membership with the Gap Plus + Benefit Boost which offers valuable coverage for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a Critical Illness for the first time, or doctor visits, labs & x-rays along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Gap Plus + Benefit Boost Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association.

Gap Plus + Benefit Boost
State Availability
AL, AR, AZ, DC, DE, FL, GA, IL, IN, IA, KY, LA, MI, MS, NE, NM, NC, ND, OH, OK, RI, SC, TN, TX, VA, VT, WV, WI, & WY

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$40 - Ind | $60 - Ind+1 | $80 - Family
Brief Group Insurance Description

GAP PLUS BOOST

Unexpected out-of-pocket expenses happen.

Group Accident Insurance

Group Accident Medical Expense Insurance

$5,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$2,500 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Physician Office Visit Benefit

$125 per day Daily Physician Office Visit Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.

Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Radiology & X-Ray Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.

Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Laboratory Tests Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.

Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Critical Illness Insurance Benefit

$5,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Critical Illness Insurance Benefit is a rider to the Group Hospital Fixed Indemnity Insurance which is underwritten by United States Fire Insurance Company.

Group Term Life Insurance

$5,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
CRITICAL ILLNESS INSURANCE BENEFIT RIDER
UNDERWRITTEN BY:
United States Fire Insurance Company

GROUP TERM LIFE INSURANCE
UNDERWRITTEN BY:
Investors Heritage Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE (WITH CRITICAL ILLNESS INSURANCE BENEFIT RIDER) & GROUP TERM LIFE INSURANCE ONLY POLICY.

The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company¹ and Investors Heritage Life Insurance Company². Your overall total association membership dues for the optional supplemental Gap Plus + Benefit Boost Product also include these monthly insurance rates

¹Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)

¹Group Hospital Fixed Indemnity Insurance:
$7.98 (Individual), $15.66 (Ind+1), $19.90 (Family)

¹Critical Illness Insurance Benefit Rider:
$3.00 (Individual), $6.00 (Ind+1), $6.00 (Family)

²Group Term Life Insurance:
$1.90 (Individual), $3.80 (Ind+1), $3.80 (Family) - in available states

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance which also includes the Critical Illness Insurance Benefit Rider is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and covers member and eligible spouse only and coverage ends at age 65. Product cost for the Gap Plus Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Crum & Forster, United States Fire Insurance Company, Investors Heritage Life Insurance Company and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AH-3460

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
  - Arizona
  - Arkansas
  - District of Columbia
  - Delaware
  - Florida
  - Georgia
  - Illinois
  - Indiana
  - Iowa
  - Kentucky
  - Louisiana
  - Michigan
  - Mississippi
  - Nebraska
  - New Mexico
  - North Carolina
  - North Dakota
  - Ohio
  - Oklahoma
  - Rhode Island
  - South Carolina
  - Tennessee
  - Texas
  - Virginia
  - Vermont
  - West Virginia
  - Wisconsin
  - Wyoming
Claim Forms

GET ACCIDENT & WELLNESS CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM

Term Life States are:
AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI,
MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA
GET TERM LIFE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Gap Plus + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Crum & Forster, United States Fire Insurance Company, and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Gap Plus Product)
Get a Quote & Apply

GET QUOTE & APPLY

GAP 10

CUT YOUR EXPENSES.

Get the upper hand on out-of-pocket expenses.

Give a boost to your UBA Membership with the Gap 10 + Benefit Boost Product which is designed to supplement your comprehensive health insurance and give you additional protection for out-of-pocket expenses for accidents or critical illnesses. Nearly identical to our Gap Basic Product benefits, but without the Group Term Life Insurance, our Gap 10 + Benefit Boost Product offers double the coverage or a $10,000 max Blanket Group Accident Medical Expense and Group Critical Illness Insurance benefit. With the Gap 10 + Benefit Boost Product, members can get the upper hand on their out-of-pocket medical expenses for covered accidents and first diagnosis of covered critical illnesses. This product offers valuable coverage for those who are accident-prone or who have a family history of cancer, heart attack or stroke along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association.

Gap 10 + Benefit Boost
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$40 - Ind | $60 - Ind+1 | $90 - Family
Brief Group Insurance Description

GAP 10 BOOST

Get the upper hand on out-of-pocket expenses.

Blanket Group Accident Insurance

Blanket Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Blanket Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Blanket Group Accident Insurance is underwritten by Sirius America Insurance Company.

Group Critical Illness Insurance

Critical Illness Insurance Benefit

$10,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $1000 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Sirius America Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

BLANKET GROUP ACCIDENT INSURANCE
& GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
Sirius America Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. COVERAGE IS PROVIDED UNDER BLANKET ACCIDENT AND GROUP CRITICAL ILLNESS INSURANCE ONLY POLICIES.

The following monthly insurance rates apply to coverage underwritten by Sirius America Insurance Company¹. Your overall total association membership dues for the optional supplemental Gap 10 + Benefit Boost Product also include these monthly insurance rates:

¹Blanket Group Accident Insurance:
$6.00(Individual), $12.00 (Ind+1), $22.61 (Family)

¹Group Critical Illness Insurance:
$6.18 (Individual), $12.36 (Ind+1), $12.36 (Family)

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Accident Insurance and Group Critical Illness Insurance are underwritten by Sirius America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Group Critical Illness Insurance Benefit Maximum is reduced if the first diagnosis occurs in the first year from the effective date. Product cost for the Gap 10 Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Sirius America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

HASA-1000 | HASA-BAM-1000

Back to Top
Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
  - Arizona
  - Arkansas
  - California
  - Colorado
  - Delaware
  - District of Columbia
  - Florida
  - Georgia
  - Illinois
  - Indiana
  - Kansas
  - Kentucky
  - Louisiana
  - Michigan
  - Mississippi
  - Missouri
  - Nebraska
  - Nevada
  - New Jersey
  - North Carolina
  - North Dakota
  - Ohio
  - Oklahoma
  - Rhode Island
  - Tennessee
  - Texas
  - Virginia
  - West Virginia
  - Wisconsin
  - Wyoming
Claim Forms

GET ACCIDENT CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Gap 10 + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Sirius America Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Gap 10 Product)
Get a Quote & Apply

GET QUOTE & APPLY

GAP MAX

MAX YOUR BENEFITS.

Expect the unexpected and be prepared.

The Gap Max + Benefit Boost Product is one of the favorite optional products among UBA Members and has similar advantages to our Gap 10 + Benefit Boost Product with some added group insurance benefits along with some higher benefit maximums. Gap Max + Benefit Boost Product offers $10,000 in Group Accident Medical Expense Insurance. This product also includes Group Hospital Fixed Indemnity Insurance for daily hospital confinement, daily emergency room visits for accidents and sickness as well as a $25,000 Critical Illness Insurance maximum lifetime benefit. Give a boost to your UBA Membership with the Gap Max + Benefit Boost which offers valuable coverage for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a critical illness or emergency room visits along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Gap Max + Benefit Boost Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association. The Product Descriptions for this version of Gap Max + Benefit Boost Product is for only the states listed below. See other Gap Max + Benefit Boost Product listings below for additional states and their correct benefit descriptions for the correct insurance carriers that underwrite the group insurance coverage in this product.

Gap Max + Benefit Boost
State Availability
AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, RI, SC, TN, VA, VT, WI, WV & WY

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$60 - Ind | $105 - Ind+1 | $130 - Family
Brief Group Insurance Description

GAP MAX BOOST

Expect the unexpected and be prepared.

Group Accident Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Critical Illness Insurance Benefit

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Critical Illness Insurance Benefit is a rider to the Group Hospital Fixed Indemnity Insurance which is underwritten by United States Fire Insurance Company.

Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
CRITICAL ILLNESS INSURANCE BENEFIT RIDER
UNDERWRITTEN BY:
United States Fire Insurance Company

GROUP TERM LIFE INSURANCE
UNDERWRITTEN BY:
Investors Heritage Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE (WITH CRITICAL ILLNESS INSURANCE BENEFIT RIDER) & GROUP TERM LIFE INSURANCE ONLY POLICY.

The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company¹ and Investors Heritage Life Insurance Company². Your overall total association membership dues for the optional supplemental Gap Max + Benefit Boost Product also include these monthly insurance rates:

¹Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)

¹Group Hospital Fixed Indemnity Insurance:
$9.04 (Individual), $18.07 (Ind+1), $31.63 (Family)

¹Critical Illness Insurance Benefit Rider:
$7.86 (Individual), $15.73 (Ind+1), $15.73 (Family)

²Group Term Life Insurance:
$3.80 (Individual), $7.60 (Ind+1), $7.60 (Family) - in available states

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance which also includes the Critical Illness Insurance Benefit Rider is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and covers member and eligible spouse only and coverage ends at age 65. Product cost for the Gap Max Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Crum & Forster, United States Fire Insurance Company, Investors Heritage Life Insurance Company and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AH-3460

Back to Top
Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
  - Arkansas
  - District of Columbia
  - Delaware
  - Florida
  - Georgia
  - Illinois
  - Indiana
  - Iowa
  - Kentucky
  - Louisiana
  - Michigan
  - Mississippi
  - Nebraska
  - New Mexico
  - North Carolina
  - North Dakota
  - Ohio
  - Oklahoma
  - Rhode Island
  - South Carolina
  - Tennessee
  - Virginia
  - Vermont
  - West Virginia
  - Wisconsin
  - Wyoming
Claim Forms

GET ACCIDENT & WELLNESS CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM

Term Life States are:
AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI,
MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA
GET TERM LIFE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Gap Max + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Crum & Forster, United States Fire Insurance Company, and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Gap Max Product)
Get a Quote & Apply

GET QUOTE & APPLY

GAP MAX

MAX YOUR BENEFITS.

Expect the unexpected and be prepared.

The Gap Max + Benefit Boost Product is one of the favorite optional products among UBA Members and has similar advantages to our Gap 10 + Benefit Boost Product with some added group insurance benefits along with some higher benefit maximums. Gap Max + Benefit Boost Product offers $10,000 in Group Accident Medical Expense Insurance. This product also includes Group Hospital Fixed Indemnity Insurance for daily hospital confinement, daily emergency room visits for accidents and sickness as well as a $25,000 Critical Illness Insurance maximum lifetime benefit. Give a boost to your UBA Membership with the Gap Max + Benefit Boost which offers valuable coverage for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a critical illness or emergency room visits along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Gap Max + Benefit Boost Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association. The Product Descriptions for this version of Gap Max + Benefit Boost Product is for only the states listed below. See other Gap Max + Benefit Boost Product listings above for additional states and their correct benefit descriptions for the correct insurance carriers that underwrite the group insurance coverage in this product.

Gap Max + Benefit Boost
State Availability
AZ, MO & TX

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$60 - Ind | $105 - Ind+1 | $130 - Family
Brief Group Insurance Description

GAP MAX BOOST

Expect the unexpected and be prepared.

Group Accident Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Critical Illness Insurance

Maximum Benefit

$25,000 Critical Illness Maximum Lifetime Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Group Critical Illness Insurance is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company.

Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
UNDERWRITTEN BY:
United States Fire Insurance Company

GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
Windsor Life Insurance Company

GROUP TERM LIFE INSURANCE
UNDERWRITTEN BY:
Investors Heritage Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE, GROUP CRITICAL ILLNESS INSURANCE & GROUP TERM LIFE INSURANCE ONLY POLICY.

The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company¹, Windsor Life Insurance Company², and Investors Heritage Life Insurance Company³. Your overall total association membership dues for the optional supplemental Gap Max + Benefit Boost Product also include these monthly insurance rates:

¹Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)

¹Group Hospital Fixed Indemnity Insurance:
$9.04 (Individual), $18.07 (Ind+1), $31.63 (Family)

²Group Critical Illness Insurance:
$10 (Individual), $20 (Ind+1), $20 (Family)

³Group Term Life Insurance:
$3.80 (Individual), $7.60 (Ind+1), $7.60 (Family) - in available states

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance are underwritten by United States Fire Insurance Company, Eatontown, NJ. Group Critical Illness is underwritten by Windsor Life Insurance Company. Coverage for Critical Illness Insurance Benefit ends at age 65 and is available to Covered Member and Eligible Spouse only. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and is available to Covered Member and Eligible Spouse only and coverage ends at age 65. Product cost for the Gap Max Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Crum & Forster, United States Fire Insurance Company, Windsor Life Insurance Company, Optimum Re, Investors Heritage Life Insurance Company and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AH-3460

Back to Top
Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Arizona
  - Missouri
  - Texas
Claim Forms

GET ACCIDENT & ER CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA
GET TERM LIFE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Gap Max + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Crum & Forster, United States Fire Insurance Company, Windsor Life Insurance Company, Optimum Life Reinsurance Company and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Gap Max Product)
Get a Quote & Apply

GET QUOTE & APPLY

GAP MAX

MAX YOUR BENEFITS.

Expect the unexpected and be prepared.

The Gap Max + Benefit Boost Product is one of the favorite optional products among UBA Members and has similar advantages to our Gap 10 + Benefit Boost Product with some added group insurance benefits along with some higher benefit maximums. Gap Max + Benefit Boost Product offers $10,000 in Group Accident Medical Expense Insurance. This product also includes Group Hospital Fixed Indemnity Insurance for daily hospital confinement, daily emergency room visits for accidents and sickness as well as a $25,000 Critical Illness Insurance maximum lifetime benefit. Give a boost to your UBA Membership with the Gap Max + Benefit Boost which offers valuable coverage for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a critical illness or emergency room visits along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Gap Max + Benefit Boost Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association. The Product Descriptions for this version of Gap Max + Benefit Boost Product is for only the states listed below. See other Gap Max + Benefit Boost Product listings above for additional states and their correct benefit descriptions for the correct insurance carriers that underwrite the group insurance coverage in this product.

Gap Max + Benefit Boost
State Availability
CA & NJ

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$60 - Ind | $105 - Ind+1 | $130 - Family
Brief Group Insurance Description

GAP MAX BOOST

Expect the unexpected and be prepared.

Group Accident Insurance

Group Accident Medical Expense Insurance

$10,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Critical Illness Insurance

Maximum Benefit

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Sirius America Insurance Company.

Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
UNDERWRITTEN BY:
United States Fire Insurance Company

GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
Sirius America Insurance Company

GROUP TERM LIFE INSURANCE
UNDERWRITTEN BY:
Investors Heritage Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE, GROUP CRITICAL ILLNESS INSURANCE & GROUP TERM LIFE INSURANCE ONLY POLICY.

The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company¹, Sirius America Insurance Company², and Investors Heritage Life Insurance Company³. Your overall total association membership dues for the optional supplemental Gap Max + Benefit Boost Product also include these monthly insurance rates:

¹Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)

¹Group Hospital Fixed Indemnity Insurance:
$9.04 (Individual), $18.07 (Ind+1), $31.63 (Family)

²Group Critical Illness Insurance:
$15.45 (Individual), $30.90 (Ind+1), $30.90 (Family)

³Group Term Life Insurance:
$3.80 (Individual), $7.60 (Ind+1), $7.60 (Family) - in available states

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance are underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Group Critical Illness Insurance is underwritten by Sirius America Insurance Company. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and is available to Covered Member and Eligible Spouse only and coverage ends at age 65. Product cost for the Gap Max Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Crum & Forster, United States Fire Insurance Company, Sirius America Insurance Company, Investors Heritage Life Insurance Company and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AH-3460 | HASA-1000

Back to Top
Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - California
  - New Jersey
Claim Forms

GET ACCIDENT & ER CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA
GET TERM LIFE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Gap Max + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Crum & Forster, United States Fire Insurance Company, Sirius America Insurance Company and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Gap Max Product)
Get a Quote & Apply

GET QUOTE & APPLY

GAP 25

CUT YOUR EXPENSES.

Get the upper hand on out-of-pocket expenses.

The Gap 25 + Benefit Boost Product mirrors our Gap 10 + Benefit Boost Product's coverage, but with one crucial difference, the total of the maximum benefits. The maximum Blanket Group Accident Medical Expense Insurance and Group Critical Illness Insurance benefit are $25,000 with the Gap 25 Product. Give a boost to your UBA Membership with the Gap 25 + Benefit Boost Product which offers valuable coverage for young families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident or being diagnosed with a Critical Illness along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Gap 25 + Benefit Boost is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association. With an affordable product cost, this optional supplemental product offers you a way to help get the upper hand on some of your out-of-pocket medical expenses.

Gap 25 + Benefit Boost
State Availability
AL, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, ND, NE, NJ, NV, OH, OK, RI, TN, TX, VA, WI, WV & WY

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$50 - Ind | $100 - Ind+1 | $120 - Family
Brief Group Insurance Description

GAP 25 BOOST

Get the upper hand on out-of-pocket expenses.

Blanket Group Accident Insurance

Blanket Group Accident Medical Expense Insurance

$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Blanket Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Blanket Group Accident Insurance is underwritten by Sirius America Insurance Company.

Group Critical Illness Insurance

Critical Illness Insurance Benefit

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Sirius America Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

BLANKET GROUP ACCIDENT INSURANCE
& GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
Sirius America Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. COVERAGE IS PROVIDED UNDER BLANKET ACCIDENT AND GROUP CRITICAL ILLNESS INSURANCE ONLY POLICIES.

The following monthly insurance rates apply to coverage underwritten by Sirius America Insurance Company¹. Your overall total association membership dues for the optional supplemental Gap 25 + Benefit Boost Product also include these monthly insurance rates:

¹Blanket Group Accident Insurance:
$8.54(Individual), $17.07 (Ind+1), $32.18 (Family)

¹Group Critical Illness Insurance:
$15.45 (Individual), $30.90 (Ind+1), $30.90 (Family)

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Blanket Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Blanket Accident Insurance and Group Critical Illness Insurance are underwritten by Sirius America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Group Critical Illness Insurance Benefit Maximum is reduced if the first diagnosis occurs in the first year from the effective date. Product cost for the Gap 25 Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Sirius America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

HASA-1000 | HASA-BAM-1000

Back to Top
Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
  - Arizona
  - Arkansas
  - California
  - Colorado
  - Delaware
  - District of Columbia
  - Florida
  - Georgia
  - Illinois
  - Indiana
  - Kansas
  - Kentucky
  - Louisiana
  - Michigan
  - Mississippi
  - Missouri
  - Nebraska
  - Nevada
  - New Jersey
  - North Carolina
  - North Dakota
  - Ohio
  - Oklahoma
  - Rhode Island
  - Tennessee
  - Texas
  - Virginia
  - West Virginia
  - Wisconsin
  - Wyoming
Claim Forms

GET ACCIDENT CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Gap 25 + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Sirius America Insurance Company does not offer and is not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Gap 25 Product)
Get a Quote & Apply

GET QUOTE & APPLY

SUPER GAP PLUS

GET IN THE FIGHT.

Fighting the battle against out-of-pocket costs.

The Super Gap Plus + Benefit Boost Product offers the ultimate coverage for critical illness, accidents, and supplemental insurance programs through UBA. Give a boost to your UBA Membership with the Super Gap Plus + Benefit Boost ideal for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a critical illness, emergency room visits, or doctor visits, labs & x-rays along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Super Gap Plus + Benefit Boost Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association. See other Super Gap Plus + Benefit Boost Product listings below for additional states and their correct benefit descriptions for the correct insurance carriers that underwrite the group insurance coverage in this product. Get in the fight against some of your out-of-pocket medical costs.

Super Gap Plus + Benefit Boost
State Availability
AL, AR, DC, DE, FL, GA, IA, IL, IN, KY, LA, MI, MS, NC, ND, NE, NM, OH, OK, RI, SC, TN, VA, VT, WI, WV & WY

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$70 - Ind | $130 - Ind+1 | $150 - Family
Brief Group Insurance Description

SUPER GAP PLUS BOOST

Fighting the battle against out-of-pocket costs.

Group Accident Insurance

Group Accident Medical Expense Insurance

$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Physician Office Visit Benefit

$125 per day Daily Physician Office Visit Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.

Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Radiology & X-Ray Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.

Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Laboratory Tests Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.

Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Critical Illness Insurance Benefit

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Critical Illness Insurance Benefit is a rider to the Group Hospital Fixed Indemnity Insurance which is underwritten by United States Fire Insurance Company.

Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
CRITICAL ILLNESS INSURANCE BENEFIT RIDER
UNDERWRITTEN BY:
United States Fire Insurance Company

GROUP TERM LIFE INSURANCE
UNDERWRITTEN BY:
Investors Heritage Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE (WITH CRITICAL ILLNESS INSURANCE BENEFIT RIDER) & GROUP TERM LIFE INSURANCE ONLY POLICY.

The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company¹ and Investors Heritage Life Insurance Company². Your overall total association membership dues for the optional supplemental Super Gap Plus + Benefit Boost Product also include these monthly insurance rates:

¹Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)

¹Group Hospital Fixed Indemnity Insurance:
$11.36 (Individual), $22.69 (Ind+1), $36.85 (Family)

¹Critical Illness Insurance Benefit Rider:
$7.86 (Individual), $15.73 (Ind+1), $15.73 (Family)

²Group Term Life Insurance:
$3.80 (Individual), $7.60 (Ind+1), $7.60 (Family) - in available states

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance which also includes the Critical Illness Insurance Benefit Rider is underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy and Certificate Rider. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and covers member and eligible spouse only and coverage ends at age 65. Product cost for the Super Gap Plus Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Crum & Forster, United States Fire Insurance Company, Investors Heritage Life Insurance Company and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AH-3460

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
  - Arkansas
  - District of Columbia
  - Delaware
  - Florida
  - Georgia
  - Illinois
  - Indiana
  - Iowa
  - Kentucky
  - Louisiana
  - Michigan
  - Mississippi
  - Nebraska
  - New Mexico
  - North Carolina
  - North Dakota
  - Ohio
  - Oklahoma
  - Rhode Island
  - South Carolina
  - Tennessee
  - Virginia
  - Vermont
  - West Virginia
  - Wisconsin
  - Wyoming
Claim Forms

GET ACCIDENT & WELLNESS CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM

Term Life States are:
AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI,
MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA
GET TERM LIFE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Super Gap Plus + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Crum & Forster, United States Fire Insurance Company, and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Super Gap Plus Product)
Get a Quote & Apply

GET QUOTE & APPLY

SUPER GAP PLUS

GET IN THE FIGHT.

Fighting the battle against out-of-pocket costs.

The Super Gap Plus + Benefit Boost Product offers the ultimate coverage for critical illness, accidents, and supplemental insurance programs through UBA. Give a boost to your UBA Membership with the Super Gap Plus + Benefit Boost ideal for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a critical illness, emergency room visits, or doctor visits, labs & x-rays along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Super Gap Plus + Benefit Boost Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association. See other Super Gap Plus + Benefit Boost Product listings above or below for additional states and their correct benefit descriptions for the correct insurance carriers that underwrite the group insurance coverage in this product. Get in the fight against some of your out-of-pocket medical costs.

Super Gap Plus + Benefit Boost
State Availability
AZ, MO & TX

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$70 - Ind | $130 - Ind+1 | $150 - Family
Brief Group Insurance Description

SUPER GAP PLUS BOOST

Fighting the battle against out-of-pocket costs.

Group Accident Insurance

Group Accident Medical Expense Insurance

$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Physician Office Visit Benefit

$125 per day Daily Physician Office Visit Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.

Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Radiology & X-Ray Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.

Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Laboratory Tests Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.

Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Critical Illness Insurance

Maximum Benefit

$25,000 Critical Illness Maximum Lifetime Benefit Amount

Maximum Lifetime Benefit Amount is $2,500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Benefit ends at age 65 and Group Critical Illness Insurance is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Windsor Life Insurance Company.

Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
UNDERWRITTEN BY:
United States Fire Insurance Company

GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
Windsor Life Insurance Company

GROUP TERM LIFE INSURANCE
UNDERWRITTEN BY:
Investors Heritage Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE, GROUP CRITICAL ILLNESS INSURANCE, & GROUP TERM LIFE INSURANCE ONLY POLICY.

The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company¹, Windsor Life Insurance Company² and Investors Heritage Life Insurance Company³. Your overall total association membership dues for the optional supplemental Super Gap Plus + Benefit Boost Product also include these monthly insurance rates:

¹Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)

¹Group Hospital Fixed Indemnity Insurance:
$11.36 (Individual), $22.69 (Ind+1), $36.85 (Family)

²Group Critical Illness Insurance:
$10 (Individual), $20 (Ind+1), $20 (Family)

³Group Term Life Insurance:
$3.80 (Individual), $7.60 (Ind+1), $7.60 (Family) - in available states

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance are underwritten by United States Fire Insurance Company, Eatontown, NJ. Group Critical Illness is underwritten by Windsor Life Insurance Company. Coverage for Critical Illness Insurance Benefit ends at age 65 and is available to Covered Member and Eligible Spouse only. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and is available to Covered Member and Eligible Spouse only and coverage ends at age 65. Product cost for the Super Gap Plus Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Crum & Forster, United States Fire Insurance Company, Windsor Life Insurance Company, Optimum Re, Investors Heritage Life Insurance Company and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AH-3460

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Arizona
  - Missouri
  - Texas
Claim Forms

GET ACCIDENT & ER CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA
GET TERM LIFE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Super Gap Plus + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Crum & Forster, United States Fire Insurance Company, Windsor Life Insurance Company, Optimum Life Reinsurance Company and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Super Gap Plus Product)
Get a Quote & Apply

GET QUOTE & APPLY

SUPER GAP PLUS

GET IN THE FIGHT.

Fighting the battle against out-of-pocket costs.

The Super Gap Plus + Benefit Boost Product offers the ultimate coverage for critical illness, accidents, and supplemental insurance programs through UBA. Give a boost to your UBA Membership with the Super Gap Plus + Benefit Boost ideal for families, people who tend to be accident-prone or with a family history of cancer, heart attack, stroke, or those that want that extra layer of protection for some of their out-of-pocket costs due to an accident, being diagnosed with a critical illness, emergency room visits, or doctor visits, labs & x-rays along with the highly regarded non-insurance benefit boost services like Virtual Urgent Care Visits with MeMD, free vitamins and more. Super Gap Plus + Benefit Boost Product is designed to help supplement your comprehensive health insurance plan for additional protection. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association. See other Super Gap Plus + Benefit Boost Product listings above for additional states and their correct benefit descriptions for the correct insurance carriers that underwrite the group insurance coverage in this product. Get in the fight against some of your out-of-pocket medical costs.

Super Gap Plus + Benefit Boost
State Availability
CA & NJ

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

Product Cost^*

$70 - Ind | $130 - Ind+1 | $150 - Family
Brief Group Insurance Description

SUPER GAP PLUS BOOST

Fighting the battle against out-of-pocket costs.

Group Accident Insurance

Group Accident Medical Expense Insurance

$25,000 Group Accident Medical Expense Insurance Annual Maximum Benefit.

$100 Deductible per accident.

Group Accidental Death & Dismemberment Insurance

$5,000 Group Accidental Death & Dismemberment Insurance Maximum Principal Sum.

Group Accident Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Hospital Confinement Benefit

$500 Daily Hospital Confinement Benefit

Days 1-3 for hospital confinement in a policy period

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Emergency Room Visit Benefit

$500 per day Daily Emergency Room Visit Benefit for Accident & Sickness

Max 10 days per policy period for Accident & Sickness

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Physician Office Visit Benefit

$125 per day Daily Physician Office Visit Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

Covered Wellness Services include: A history and physical examination & immunizations as provided by department of health regulation.

Note: The Wellness Visit for Daily Physician Office Visit Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Radiology & X-Ray Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

Daily Outpatient Diagnostic Radiology & X-Ray benefit does not include Radiation Therapy.

Note: The Wellness Visit for Daily Outpatient Diagnostic Radiology & X-Ray Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Hospital Fixed Indemnity Insurance

Daily Outpatient Diagnostic Laboratory Tests Benefit

$75 per day Daily Outpatient Diagnostic Laboratory Tests Benefit

2 visits - Max 1 day per plan year for medically necessary visit and an additional 1 day for other Wellness visit.

In addition to medically necessary treatment, we will also cover wellness care for outpatient diagnostic laboratory tests to the extent that they are provided by, or under the supervision of, a single technician during the course of one visit.

Note: The Wellness Visit for Daily Outpatient Diagnostic Laboratory Tests Benefit is not available in the state of Michigan.

Group Hospital Fixed Indemnity Insurance is underwritten by United States Fire Insurance Company.

Group Critical Illness Insurance

Maximum Benefit

$25,000 Critical Illness Benefit Lifetime Maximum Benefit Amount

Maximum Lifetime Benefit Amount is $2500 if first diagnosis of a Covered Critical Illness occurs within the first year from the effective date. Invasive Cancer benefit will not be paid if Proof of Loss occurs prior to 45 days from the effective date. Benefit ends at age 65 and Critical Illness Insurance Benefit is only available for Covered Member and their Eligible Spouse.

Group Critical Illness Insurance is underwritten by Sirius America Insurance Company.

Group Term Life Insurance

$10,000 Principal Sum Maximum Benefit

Benefit ends at age 65 and Group Term Life Insurance is only available for Covered Member and their Eligible Spouse.

Group Term Life Insurance for this plan is only available in the following states: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA.

Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP ACCIDENT INSURANCE &
GROUP HOSPITAL FIXED INDEMNITY INSURANCE
UNDERWRITTEN BY:
United States Fire Insurance Company

GROUP CRITICAL ILLNESS INSURANCE
UNDERWRITTEN BY:
Sirius America Insurance Company

GROUP TERM LIFE INSURANCE
UNDERWRITTEN BY:
Investors Heritage Life Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A GROUP ACCIDENT & HOSPITAL FIXED INDEMNITY INSURANCE, GROUP CRITICAL ILLNESS INSURANCE, & GROUP TERM LIFE INSURANCE ONLY POLICY.

The following monthly insurance rates apply to coverage underwritten by United States Fire Insurance Company¹, Sirius America Insurance Company², and Investors Heritage Life Insurance Company³. Your overall total association membership dues for the optional supplemental Super Gap Plus + Benefit Boost Product also include these monthly insurance rates:

¹Group Accident Insurance:
$5.42 (Individual), $10.87 (Ind+1), $19.00 (Family)

¹Group Hospital Fixed Indemnity Insurance:
$11.36 (Individual), $22.69 (Ind+1), $36.85 (Family)

²Group Critical Illness Insurance:
$15.45 (Individual), $30.90 (Ind+1), $30.90 (Family)

³Group Term Life Insurance:
$3.80 (Individual), $7.60 (Ind+1), $7.60 (Family) - in available states

Read the Certificate(s) of Insurance carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Group Accident Insurance and Group Hospital Fixed Indemnity Insurance are underwritten by United States Fire Insurance Company, Eatontown, NJ. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Group Critical Illness Insurance is underwritten by Sirius America Insurance Company. Covered Critical Illnesses are subject to the definitions, limitations and exclusions of the Group Policy. Coverage for Critical Illness is for Member and eligible Spouse between the ages of 18-64. Benefit for Group Critical Illness Insurance ends at age 65. Benefits are paid at 10% of the Benefit Maximum if first diagnosis occurs in the first year from the effective date. Group Term Life Insurance is underwritten by Investors Heritage Life Insurance Company and is available to Covered Member and Eligible Spouse only and coverage ends at age 65. Product cost for the Super Gap Plus Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Crum & Forster, United States Fire Insurance Company, Sirius America Insurance Company, Investors Heritage Life Insurance Company and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

AH-3460 | HASA-1000

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - California
  - New Jersey
Claim Forms

GET ACCIDENT & ER CLAIM FORM

GET CRITICAL ILLNESS CLAIM FORM

Term Life States are: AL, AR, AZ, CA, FL, GA, IL, IN, KY, MI, MO, MS, NE, NM, OH, OK, PA, SC, TN, TX & VA
GET TERM LIFE CLAIM FORM
Non-Insurance UBA Benefit Boost Services (included in this Product)

Benefit Boost Services

Non-Insurance Services included in this product.

This product includes Benefit Boost Subscription Services which are: telehealth (urgent visits and talk therapy) with MeMD^®, free gummy multi-vitamins, retail prescription & pet prescription discounts, Aetna Dental Access discounts, and Identity theft protection with LifeLock^®.

All Benefit Boost Services are not Insurance and are separate services from the insurance as part of this optional membership product. Benefit Boost services are subject to change when needed.

As part of your overall Super Gap Plus + Benefit Boost Product cost, the non-insurance Benefit Boost Subscription services retail at $25 (Individual), $40 (Ind+1), $60 (Family).

If you purchased the Virtual PCP Solution Subscription Membership with the Benefit Boost Subscription Membership, the MeMD^® membership services will be based on the Virtual PCP Solution Subscription services with MeMD^®.

Crum & Forster, United States Fire Insurance Company, Sirius America Insurance Company, Optimum Life Reinsurance Company and Investors Heritage Life Insurance Company do not offer and are not affiliated with the additional non-insurance Benefit Boost services and discount programs offered in connection with membership in the United Business Association (UBA).

VIEW DETAILS ON BENEFIT BOOST SERVICES

(Non-Insurance Benefit Boost Services
are included in the Super Gap Plus Product)
Get a Quote & Apply

GET QUOTE & APPLY

UBA DENTAL

BRIGHTER SMILES.

Get regular cleanings & protect your oral health.

The UBA Dental Product is valuable coverage for families, people who want to get regular dental check-ups, or those that just want that extra layer of protection for some of their out-of-pocket costs due to diagnostic, preventive, basic, or major dental services. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association.

UBA Dental State Availability
AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, ID, IL, IN, IA, KY, LA, MA, MI, MS, MO, ND, NE, NJ, NM, NV, OH, OK, PA, SC, TN, TX, VA, WV, WI & WY

This Optional Product includes Group Insurance Only.

Product Cost^*

Product cost varies by state & area. Get a Quote.
Brief Group Insurance Description

UBA DENTAL

Get regular cleanings & protect your oral health.

Group Dental Insurance

$1,000 annual maximum
(Plus maximum carryover^*)

$50 individual and $150 family annual deductible

^*Maximum carryover: If at least one covered service is paid in a benefit year and the total benefit paid does not exceed $500 in that benefit year, $250 will be added to the next benefit year carryover maximum. This amount will accumulate from one benefit year to the next, but will not exceed $1,000.

DIAGNOSTIC & PREVENTIVE

100% - Diagnostic & preventive services

In-network or out-of-network coverage (as defined by the policy).

BASIC SERVICES

70% - Basic dental services

In-network or out-of-network coverage (as defined by the policy).

MAJOR DENTAL SERVICES

50% - Major dental services

In-network or out-of-network coverage (as defined by the policy).

There is a 12-month waiting period for all major dental services.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP DENTAL INSURANCE UNDERWRITTEN BY:
Renaissance Life & Health Insurance Company of America

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THIS IS DENTAL INSURANCE AND NOT MAJOR MEDICAL INSURANCE.

Read the group insurance certificates carefully. This is a brief description of Association Group Dental Insurance and is not an insurance contract, nor part of the insurance policy and is subject to the terms, conditions, limitations, and exclusions of the policy. Coverage may vary or may not be available in all states. You'll find complete coverage details in the policy certificate. Insurance benefits are underwritten by Renaissance Life & Health Insurance Company of America, Indianapolis, IN and in New York by Renaissance Life & Health Insurance Company of New York, Binghamton, NY. Both companies ("Renaissance") can be reached at Po Box 1596, Indianapolis, IN, 46206. There is no ownership affiliation between Renaissance and UBA Dental & Vision. For complete coverage details, please refer to the certificate of insurance. Product cost for the UBA Dental Product does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Renaissance Life & Health Insurance Company of America and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
  - Arizona
  - Arkansas
  - California
  - California
  - Connecticut
  - District of Columbia
  - Delaware
  - Florida
  - Georgia
  - Idaho
  - Illinois
  - Indiana
  - Iowa
  - Kentucky
  - Louisiana
  - Michigan
  - Mississippi
  - Missouri
  - Nebraska
  - Nevada
  - New Jersey
  - New Mexico
  - North Dakota
  - Ohio
  - Oklahoma
  - Pennsylvania
  - South Carolina
  - Tennessee
  - Texas
  - Virginia
  - West Virginia
  - Wisconsin
  - Wyoming
Claim Forms

GET DENTAL CLAIM FORM
Dental Providers

VIEW DENTAL PROVIDERS
Get a Quote & Apply

GET QUOTE & APPLY

UBA VISION

SEE MORE CLEARLY.

Get regular eye exams & take care of your eyes.

The UBA Vision Product is valuable coverage for families, people who want to get regular vision check-ups, or those that just want that extra layer of protection for some of their out-of-pocket expenses due to vision exams, frames, lenses and contacts. This optional supplemental UBA Gap Product helps to enhance and add more value to your membership in the United Business Association.

UBA Vision State Availability
AL, AR, AZ, CA, DC, DE, FL, GA, ID, IN, KY, LA, MI, MS, MO, ND, NE, NJ, NM, NV, OH, OK, PA, SC, TN, TX, VA, VT, WV, WI & WY

This Optional Product includes Group Insurance Only.

Product Cost^*

$14 - Ind | $27 - Ind+1 | $43 - Family
Brief Group Insurance Description
UBA VISION

Get regular eye exams & take care of your eyes.

Group Vision Insurance

Well Vision Exam: $10 copay every 12 months

In-network coverage

Prescription glasses: $25 copay every 12 months

(see frames & lenses below) - in-network coverage

Frames: $130 allowance

In-network coverage

(for a wide selection of frames: 20% savings on amount over your allowance)

Lenses: single vision, lined bifocal, lined trifocal & lenticular lenses. Polycarbonate lenses for dependent children.

Lens enhancements - progressive lenses - every 12 months

In-network coverage
- Standard: $55
- Premium: $95-$105
- Custom: $150-$175
Contacts (instead of glasses)

In-network coverage
- Copay for contacts (applies to evaluation & fitting): up to $60 every 12 months
- Allowance for contacts (copay does not apply): $130 allowance
- Contact lens exam (evaluation & fitting): Medically necessary covered in full after $25 copay.
When contact lenses are obtained, the covered person shall not be eligible for lenses and frames again in the next 12 months.

Out-of-network Coverage:
Exams up to $45 & frames up to $70

Additional out-of-network coverage:
- Single vision lenses: up to $30
- Lined bifocal lenses: up to $50
- Lined trifocal lenses: up to $65
- Progressive lenses: up to $50
- Lenticular lenses: up to $100
- Contact lenses: up to $105 - (medically necessary contact lenses: up to $210)
Coverage with a retail chain affiliate may be different. Visit VSP.com for details if you plan to see a provider other than a VSP doctor.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP VISION INSURANCE UNDERWRITTEN BY:
Renaissance Life & Health Insurance Company of America

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

THIS IS VISION INSURANCE AND NOT MAJOR MEDICAL INSURANCE.

Read the group insurance certificates carefully. This is a brief description of Association Group Vision Insurance and is not an insurance contract, nor part of the insurance policy and is subject to the terms, conditions, limitations, and exclusions of the policy. Coverage may vary or may not be available in all states. You'll find complete coverage details in the policy certificate. Insurance benefits are underwritten by Renaissance Life & Health Insurance Company of America, Indianapolis, IN and in New York by Renaissance Life & Health Insurance Company of New York, Binghamton, NY. Both companies ("Renaissance") can be reached at Po Box 1596, Indianapolis, IN, 46206. There is no ownership affiliation between Renaissance and UBA Dental & Vision. For complete coverage details, please refer to the certificate of insurance. Product cost for the UBA Vision Product does not include the $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this product.

United Business Association, Renaissance Life & Health Insurance Company of America and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

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Certificates of Insurance (Limitations & Exclusions)
- CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  - Alabama
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  - Arkansas
  - California
  - Colorado
  - Connecticut
  - District of Columbia
  - Delaware
  - Florida
  - Georgia
  - Idaho
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  - Indiana
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  - South Carolina
  - Tennessee
  - Texas
  - Virginia
  - Vermont
  - West Virginia
  - Wisconsin
  - Wyoming
Claim Forms

GET VISION CLAIM FORM

Note: If using a VSP provider, claim form is not needed.
Vision Providers

VIEW VISION PROVIDERS
Get a Quote & Apply

GET QUOTE & APPLY

ASSOCIATION MEMBERSHIP, NON-INSURANCE PRODUCTS & OPTIONAL SUPPLEMENTAL GROUP INSURANCE PRODUCTS NATIONWIDE.

FIND OUT WHAT UBA OFFERS

UBA MEMBERSHIP PRODUCTS

Reasons to Enroll in the Association

United Business Association Membership

Enhance Your Existing Insurance with a Product That's Right for You.

Discover an Optional UBA Gap Product that Matches Your Needs

What is the Application Process to Join UBA, Add Benefit Boost or Virtual PCP Monthly Subscription or Add an Optional UBA Gap Product that includes Group Insurance?

Review All Membership Products available with United Business Association:

UBA MEMBERSHIP

MEMBER DRIVEN VALUE.

Unlock the value of your UBA Membership.

This Monthly Association Membership includes Non-Insurance Services Only

UBA MEMBERSHIP

Unlock the value of your UBA Membership.

Business Services of UBA Membership

Lifestyle Services of UBA Membership

Networking with UBA

Optional Group Supplemental Insurance

THIS IS AN ASSOCIATION MEMBERSHIP.

BENEFIT BOOST

IMPROVING HEALTH.

A strategy to boost your overall health.

This Monthly Subscription Membership includes Non-Insurance Services Only

BENEFIT BOOST SUBSCRIPTION

A strategy to boost your overall health.

Telehealth Service with MeMD®

Free Gummy Multi-Vitamins

Retail RX & Pet RX Discounts

Dental Discounts with Aetna Dental Access® Network

Identity Theft Protection with LifeLock®

THIS IS A MONTHLY SUBSCRIPTION MEMBERSHIP AND IS NOT INSURANCE.

VIRTUAL PCP SOLUTIONWITH MeMD®

VIRTUAL PRIMARY CARE.

Primary care for the modern world.

This Monthly Subscription Membership includes Non-Insurance Services Only

VIRTUAL PCP SOLUTIONWITH MeMD®

Primary care for the modern world.

VIRTUAL PRIMARY CARE VISITS WITHIN 24 HRS

Virtual Urgent Care & Talk Therapy Visits

Lab Work & Imaging with Virtual PCP Solution

Ongoing Chronic Care Management

Continuity of Care

1:1 Care Navigation Team

Retail Prescription Discounts with Paramount RX

THIS IS A MONTHLY SUBSCRIPTION MEMBERSHIP AND IS NOT INSURANCE.

COMPLEMENT CARE

TAKE CARE OF YOURSELF.

Complement traditional health insurancewith ER & Dr visits.

This Optional Product includesGroup Insurance Only

COMPLEMENT CARE

Complement traditional health insurancewith ER & Dr visits.

Group Hospital Indemnity Insurance

Group Hospital Indemnity Insurance

Group Hospital Indemnity Insurance

Group Hospital Indemnity Insurance

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. COVERAGE IS PROVIDED UNDER GROUP HOSPITAL INDEMNITY INSURANCE ONLY POLICIES.

GAP AME 10K

ACCIDENTS HAPPEN.

Life is unpredictable and sometimes we get hurt.

This Optional Product includesGroup Insurance Only

GAP AME 10K

Life is unpredictable and sometimes we get hurt.

Group Accident Only Insurance

Group Accident Only Insurance

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS GROUP ACCIDENT ONLY INSURANCE.

GAP AME 10K

ACCIDENTS HAPPEN.

Life is unpredictable and sometimes we get hurt.

This Optional Product includes Group Insurance &Benefit Boost Non-Insurance Services

GAP AME 10K BOOST

Life is unpredictable and sometimes we get hurt.

Group Accident Only Insurance

Group Accident Only Insurance

THE INSURANCE PORTIONS OF THIS PRODUCT PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS GROUP ACCIDENT ONLY INSURANCE.

Benefit Boost Services

GAP BASIC

GAP YOUR DEDUCTIBLE.

Don't break the bank for out-of-pocket expenses.

This Optional Product includes Group Insurance &Benefit Boost Non-Insurance Services

This Monthly Association Membership includes
Non-Insurance Services Only

This Monthly Subscription Membership includes
Non-Insurance Services Only

Telehealth Service with MeMD^®

Dental Discounts with Aetna Dental Access^® Network

Identity Theft Protection with LifeLock^®

VIRTUAL PCP SOLUTION
WITH MeMD^®

This Monthly Subscription Membership includes
Non-Insurance Services Only

VIRTUAL PCP SOLUTION
WITH MeMD^®

Complement traditional health insurance
with ER & Dr visits.

This Optional Product includes
Group Insurance Only

Complement traditional health insurance
with ER & Dr visits.

This Optional Product includes
Group Insurance Only

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services

This Optional Product includes Group Insurance &
Benefit Boost Non-Insurance Services