FAQs and Fine Print

Frequently Asked Insurance Questions

Up to $25,000 in AME Coverage:
Many health policies have a high deductible due to the constant increases in health care costs. The average trip to an emergency room could require you to pay hundreds of dollars out-of-pocket! Can you afford this sudden expense?


You never know when an accident will happen, but when it does you should be prepared. Whether you have existing coverage through another plan, or are currently without any coverage, our accident insurance protection provides an affordable option to help reduce your out-of-pocket expenses, so you are not burdened with the costs often brought on from such an unexpected event.


Take a look at the benefits you'll receive and just imagine the peace-of-mind this plan provides.


ALSO INCLUDES:
Continuous Care Benefit
Family Care Benefit
Service Dog Benefit

(see details below)


WHEN COVERAGE APPLIES:
Accident Insurance provides coverage 24 hours a day - worldwide - while on business or pleasure.


AME BENEFIT DESCRIPTION:
Accident Medical Expense Benefit Amounts for Members and their spouses/domestic partners and dependent children:

$2,500 or $5,000 AME benefit subject to a deductible of $195 per claim.


WBA will pay $95 of your deductible as a member benefit

$7,500, $10,000, $15,000, $20,000, or $25,000 AME benefit subject to a deductible of $275 per claim.


WBA will pay $175 of your deductible as a member benefit

Deductible reduction benefit shall not exceed member annual paid dues per year based on membership start date.

This benefit will reimburse medical expenses up to the maximum elected if accidental bodily injury causes an insured person to first incur medical expenses for care and treatment of the accidental bodily Injury within 60 days after an accident. The benefit amount for Accident Medical Expense is payable only for medical expenses incurred within 365 days after the date of the accident causing the accidental bodily Injury. The benefit amount is subject to a deductible. The deductible will be deducted from any benefit amount for Accident Medical Expense that the insurance company pays. This deductible applies separately to each insured person and each accident.


NOTICE OF CLAIM - Written notice of claim must be given to Us within 60 days after a Covered Loss occurs or begins or as soon as reasonably possible.
Failure to give notice within such time shall not invalidate nor reduce any claim if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible. Notice can be given at Our administrative office as shown on the cover page or to Our agent. Notice should include the Policyholder's name and number and a Covered Person's name and address.


ACCIDENT MEDICAL and DENTAL EXPENSE BENEFIT:
We will pay Accident Medical and Dental Expense Benefits for Covered Expenses that result directly, and from no other cause, from a Covered Accident. These benefits are subject to the Deductibles, Benefit Periods, Maximum Benefit Amounts and other terms or limits shown below and in the Schedule of Benefits. Accident Medical Expense Benefits are only payable: (1) for Usual and Customary charges incurred after the Deductible has been met; (2) for those Medically Necessary Covered Expenses incurred by or on behalf of the Covered Person; (3) for Covered Expenses incurred within 365 days after the date of the Covered Accident. No benefits will be paid for any expenses incurred that are in excess of Usual and Customary charges.


AME Excluded Expenses:
The following will not be considered Covered Expenses unless coverage is specifically provided: 1. Any service, treatment or supply that is not considered appropriate treatment as defined in this Rider; 2. Expenses Incurred after the end of the Benefit Period, even if Incurred for continuing services or treatment of a Covered Injury; 3. cosmetic surgery or care, or treatment solely for cosmetic purposes, or complications therefrom. This exclusion does not apply to: (a) cosmetic surgery resulting from a Covered Accident, if initial treatment of the Covered Person is begun within 12 months of the date of the Covered Accident; (b) reconstruction incidental to or following surgery resulting from a Covered Accident; (c) any unplanned and unintended adverse consequences that may result during the treatment of a Covered Accident; 4. Any elective or routine treatment, surgery, health treatment, or examination, including any service, treatment or supplies that: (a) are deemed to be experimental or investigational; and (b) are not recognized and generally accepted medical practice in the United States; 5. Treatment in any Veteran’s Administration, Federal, or state facility, unless there is a legal obligation to pay; 6. Services or treatment provided by persons who do not normally charge for their services unless there is a legal obligation to pay; 7. Rest cures or custodial care; 8. Personal services such as television and telephone or transportation; 9. Expenses payable by any automobile insurance policy without regard to fault; 10. Services or treatment provided by an infirmary operated by the Policyholder; 11. Treatment of injuries that result over a period of time (such as blisters, tennis elbow, etc.); 12. Treatment or service provided by a private duty nurse; 13. Repair or replacement of existing artificial limbs, eyes, and larynx, unless damaged or destroyed in a Covered Accident; 14. Treatment of hernia of any kind; 15. Treatment of an injury resulting from a condition that the Covered Person knew existed on the date of a Covered Accident unless we have received a written medical release from his Physician.; 16. Treatment of an injury resulting from or contributed to by frostbite, fainting or seizures, or heatstroke or heat exhaustion; 17. Sickness, disease, bodily or mental infirmity or medical or surgical treatment thereof, bacterial, or viral infection, regardless of how contracted. This does not include bacterial infection that is the natural foreseeable result of an accidental external bodily injury or accidental food poisoning.



ALSO INCLUDES:
Continuous Care Benefit (CCB) - $250 Per Day

If a Covered Person is Confined to a Hospital for treatment of an Accidental Injury and upon discharge requires Continuous Care, the Company will pay the Continuous Care benefit amount of $250 per day, payable for a maximum of 20 days. Continuous Care means care received in a Skilled Nursing Facility or Home Health Care or Hospice care in connection with the condition for which they were Hospitalized. The following conditions must be met before Continuous Care benefits are payable:
1. Continuous Care must begin within 21 days following discharge from Inpatient care in a Hospital;
2. Continuous Care must be for the same Accidental Injury for which the Covered Person was Hospitalized;
3. the Continuous Care must be prescribed by a Physician and must be Medically Necessary for the care and treatment of the Covered Person’s condition;
4. the Covered Person must be in Continuous Care for a minimum of 72 hours;
5. Home Health Care services must be performed by a Home Health Care Agency. Home Health Care services cannot be performed by a person who lives with the Covered Person or by the Covered Person’s Immediate Family Member; and
6. Hospice care services require:
(a) a written statement from the attending Physician that the Covered Person has a life expectancy of six (6) months or less; and
(b) a written statement from the Hospice certifying the days that services were provided. The daily benefit is payable once per day regardless of how many Continuous Care services are provided on that day. No benefits are payable if the Covered Person is Hospital Confined.


Family Care Benefit (FCB) - $100 Per Day

If a Covered Person is Hospital Confined or Confined in a Rehabilitation Unit as a result of an Accidental Injury and has a child(ren) attending a Day Care Center, We will pay the Family Care benefit amount of $100 per day, up to a maximum number of 20 days. We will require a paid receipt from the Day Care Center that shows that the child(ren) was (were) at the Day Care Center for the same dates that the Covered Person was Hospital Confined or Confined in the Rehabilitation Unit. The child(ren) does (do) not have to be Covered Persons but do have to meet the definition of Dependent.


Service Dog Benefit (SDB) - $2,000 (one time)

If a Covered Person sustains an Accidental Injury and as a result a Physician recommends that the Covered Person would benefit from a Service Dog, the Company will pay the one-time-only Service Dog benefit of $2000. Benefits payable are limited to one service dog per Covered Person per Accident. The following conditions must be met:
1. the Covered Person is covered under the Policy when the Service Dog is placed with the Covered Person; and
2. the Covered Person purchases the Service Dog from an organization accredited by Assistance Dogs International (ADI) or the International Guide Dog Federation (IGDF); and
3. the Service Dog is placed with the Covered Person within 180 days after the Accident; and
4. the Covered Person provides proof of purchase.

Fine Print

We try to avoid fine print and twisted legal terminology. The few items you will find here are direct and easy to understand.

Benefit Changes
All benefits are subject to revision or change. WBA works with multiple outside vendors who may occasionally make changes to the services offered to members. Any benefit changes will be communicated to existing members as rapidly as possible. WBA will continue to seek better and more effective benefits and services for the membership at the best possible prices. Any new benefits will be made available to all existing members unless restricted by local law or regulation.

Banking and credit cards
WBA currently has contracted with the Comprehensive Insurance Agency, LLC to handle the sales and billing of membership services. That name may appear on your bank or credit card statement if you use any of our automated debit methods to pay your dues.

Refund Policy
WBA offers you a 30 day money back guarantee. If for any reason you decide to cancel your membership within the first 30 days after enrollment or effective date (whichever is later), we will refund your dues, no questions asked.

After the initial guarantee period has passed, refunds will be based on the following 1st day of the month 30 days AFTER your written request to cancel your membership. Cancellation requests must be in writing or via email. The member will be refunded the unused portion, if any, of dues paid in advance.

Please be aware that WBA incurs non-recoverable expenses each time your credit card or bank account is debited or credited. Member dues for the coming month will not be refunded if the electronic transfer has already taken place.

Privacy Policy

Wholesale Benefits Association, Comprehensive Insurance Agency, LLC and any of their subsidiaries or sub-contractors will not release, sell, trade or give any information regarding our customers to any third party. The information that you provide will only be used to process your enrollment and in communicating with you in the future. We will, at times, send you updates, via e-mail and other means, regarding product changes, new benefits and services, as well as new products and special offers.

WBA uses a true Secure Application system to assure the confidentiality of your personal information. For complete details, please visit the 
Plug'N'Pay web site.

KEEP IN TOUCH

Fill out the form below and we will get back to you promptly with the information you need.

Contact Us

Health Insurance Alternatives