THE TRAVEL ACCIDENT INSURANCE PLAN
The Travel Accident Plan is a company paid Plan which provides benefits in case of
accidental death, dismemberment, or paralysis which is due to a covered accident
occurring while traveling on business for Union College anywhere in the world.
This booklet describes the main provisions of the Plan and the range of benefits available
which are provided at no cost to you. The Plan provisions are governed by the Insurance
Contract issued by CIGNA Life Insurance Company of New York. If you have any
questions after reading this booklet, contact your Human Resources Department.
All employees who are traveling on behalf of Union College.
Your amount of coverage is $300,000.
Total Limit Of Liability
The Plan will not pay more than $500,000 per Accident.
If, but for this provision, the Plan would pay more than this amount, then the benefits the
Plan will pay to each covered person as the result of the same accident will be reduced in
the same proportion, so that the total amount the Plan will pay is the maximum amount
The Plan will pay the benefits described for any accident which occurs anywhere in the
world while you are on a business trip and traveling or making a short stay:
a) away from your premises in your city of permanent assignment; and
b) are on business for Union College.
All such trips must be authorized by Union College.
This coverage does not include commuting between your home and place of work; or
“Personal Deviation” means an activity that is not reasonably related to Union College
business; is not incidental to Union College business.
This coverage will start at the actual start of a trip. It does not matter whether the trip
starts at your home, place of work, or other place. This coverage will end when you
return to your home or place of work, whichever happens first; or makes a personal deviation.
If you travel to another city, and are expected to remain there for more than 60 days, this
shall be deemed a change in your city of permanent assignment.
Air travel is included while flying as a passenger only, in any civilian aircraft having a
current and valid airworthiness certificate and piloted by a person who then holds a valid
and current certificate of competency of a rating authorizing him/her to pilot such
The Plan will pay the benefits for a covered loss by you from an accident which is caused
by an Act of Terrorism during business travel to the extent that this coverage is not
provided by the plan.
“Acts of Terrorism” means violence which:
1. committed against non-combatants; and
2. premeditated and politically motivated; and
3. is committed by:
a. a person or persons not acting on behalf of a sovereign state; or
b. clandestine state agents.
4. occurs within the United States, its territories and possessions.
Benefits will not be paid for losses caused by or resulting from nuclear radiation or the
release of nuclear energy.
The Plan will pay for benefits for a covered loss from an accident which occurs while you
are on Union College’s premises and which the loss results from a bomb explosion.
“Bomb” means any real or dummy explosive device placed with intent to scare, cause
injury or unlawful property damage.
“Bomb Explosion” means any artificially induced explosion where it appears that the
explosion was intended to cause injury or unlawful property damage. It does not include
any act of declared or undeclared war in the United States or Canada; or acceptance of
known explosives as cargo.
Exposure And Disappearance
This coverage includes exposure to the elements, after the forced landing, stranding,
sinking, or wrecking of a vehicle in which you were traveling on business for Union
You will be presumed to have died, for purposes of this coverage, if:
a) you are in a vehicle which disappears, sinks, or is stranded or wrecked, in the course
of a trip which would be covered by the policy; and
b) your body is not found within a year of the accident.
Accidental Death, Dismemberment and Paralysis Benefits
When a covered injury results in any of the following losses to you within 365 days after
the date of the accident, the Plan will pay in one sum the indicated percentage of the
Principal Sum for:
Percentage of Benefit Amount
Loss of Life…………………………………………...………………………………100%
Two or more members………….…………………………………………..………...100%
Both Speech and Hearing..…….……………………………………………………..100%
Either Speech or Hearing.……….……………………………………………………..50%
Thumb and index finger of the same hand……………………….……………….…...25%
Quadriplegia (total paralysis of both upper and lower limbs)…………………..……100%
Paraplegia (total paralysis of both lower limbs)…..………………………………...…50%
Hemiplegia (total paralysis of upper and lower limbs on one side of the body)………50%
“Member” means hand, foot and eye.
“Loss” means, with regard to hand or foot, complete severance through or above the wrist
or ankle joint; loss of an eye means total and irrecoverable loss of sight in the eye. Loss
of a thumb and index finger means complete severance through or above the
metacarpophalangeal joints (the joints between the fingers and the hand). Loss of speech
means the permanent loss of all ability to communicate by speech. Loss of hearing
means its total, permanent loss, which cannot be corrected by any hearing aid. (In
California, loss of a thumb and index finger means loss by complete severance of at least
one whole phalanx of each.) (In South Carolina, the loss of four whole fingers from one
hand equals the loss of one hand.)
“Paralysis” means loss of use, without severance of a limb. This loss must be determined
by a physician to be complete and not reversible.
If you suffer more than one loss from an accident, the Plan will only pay for the loss with
the larger benefit.
Seat Belt Benefit (Business Travel Only)
The Plan will pay an accidental death benefit of a minimum of $1,000 up to a maximum
of 10% of your benefit not to exceed $10,000. The Plan will pay this benefit if you suffer
loss of life, as the result of a covered accident which occurs while you were driving or
riding in a Private Passenger Car, if:
1. The car is equipped with seatbelts; and
2. The seatbelt was in actual use and properly fastened at the time of the accident; and
3. The position of the seatbelt is certified in the official report of the accident; or by the
investigating officer. A copy of the police accident report must be submitted with the
If such certification is not available, and it is unclear whether you were properly wearing
a seatbelt, then the Plan will pay a fixed benefit of $1,000 to the designated beneficiary.
“Private Passenger Car” means: a validly registered four-wheel private passenger car
(including Policyholder-owned cars), station wagons, jeeps, pick-up trucks, and van-type
In the case of a child, seatbelt means a child restraint, as required by state law and
approved by the National Highway Traffic Safety Administration, properly secured and
being used as recommended by its manufacturer for children of like age and weight at the
time of the accident.
Unless otherwise provided, the Plan will pay benefits only once for any one covered loss,
even if it was caused by more than one covered hazard.
Travel Assistance Services
Travel Assistance Services are available to you 24-hours a day, 365 days a year while
traveling on company business at least 100 miles from your place of residence. Services
range from pre-departure information to replacing lost passports to coordinating emergency
medical evacuations. Please call 1-800-226-4567 within the US and Canada or call collect
1-202-331-7635 from any other location. Travel Assistance Services are provided by
Worldwide Assistance Services, Inc. (WA). Worldwide Assistance ID Cards are available.
Please see your Human Resources Department.
Emergency Medical Evacuation Benefit
When necessary, WA will arrange and pay for your transportation to the nearest adequate
medical facility that can properly treat your condition. You must suffer and injury or
sickness and be traveling outside the United States on Union College business to qualify for
this benefit. The maximum benefit amount is $50,000.
If you die while traveling outside the United States on Union College business, WA will
arrange all necessary government authorizations and pay for the return of your remains to
your place of residence for burial up to a maximum benefit amount of $10,000.
Benefit Limitation under Emergency Medical Evacuation and Rpatriation
Benefits will not be paid for services that are not approved in advance by WA; and
expenses paid or payable by any health or accident insurance or assistance plan covering
you which is sponsored by Union College; and expenses for which benefits are provided
under Worker’s Compensation occupational disease or similar law which would pay
benefits in the absence of this insurance.
You may name a beneficiary for this Plan. If a beneficiary designation does not exists,
then loss of life benefits will be paid to the first of the following survivors:
1) your Spouse;
2) your Children, equally;
3) your Parents, equally;
4) your Brother and Sisters, equally or
5) your estate.
All other benefits provided by the Plan will be paid to you.
You may change your beneficiary at any time by completing a Change of Beneficiary
Form. Forms are available from and should be returned to your Human Resources
Exclusions and Plan Limitations
The plan will not pay benefits for loss caused by or resulting from:
a) Suicide, attempted suicide, or whenever you injurer yourself on purpose;
b) War or acts of war, whether or not declared occurring in the United States, any
nation of which you are a citizen, Afghanistan, Algeria, Bosnia-Herzegovina,
Iran, Iraq, Israel, Kosovo, Lebanon, Libya, Macedonia, Pakistan, Turkmenistan,
Uzbekistan and Yugoslavia (Sebia and Montenegro).
c) Injury while you are on full time active duty in any armed forces.
d) Taking part in a felony.
e) Travel or flight in any spacecraft; or flight in any aircraft, except to the extent that
this hazard is provided for by name in the policy.
f) Any bacterial infection that was not caused by an accidental cut, wound or food
This is an accident only policy. The Plan will not pay benefits for loss caused by or
resulting from illness, disease, or bodily infirmity.
Termination of Coverage
Your coverage under this Plan will continue until:
• your employment ends; or
• the Plan is terminated.
The insurance company, CIGNA Life Insurance Company of New York (CLICNY),
cannot terminate the master policy except on the renewal date and then only by giving
written notice thirty-one (31) days prior to that date.
Business Travel Accident Component of the Welfare Benefit Plan
Trustees of Union College
Plan Identification Number
The Plan is identified by the following numbers:
The Employer Identification Number (EIN) assigned by the IRS, is 14-1338580.
The Plan Number assigned by Trustees of Union College is ABY-011065.
The Group Number is 57.
Trustees of Union College
The master policy between Trustees of Union College and CIGNA Life Insurance
Company of New York (CLICNY) govern the operation of the Plan which is
administered directly by the Plan Administrator, which is Trustees of Union College.
The costs for your benefits under the Plan are paid completely by Trustees of Union
How to File a Claim
Your beneficiary, in the event of your accidental death, or you, in the case of an
accidental dismemberment, or paralysis, should contact your Human Resources
Department. A certificate of death with the raised seal will be required, along with any
other pertinent information, such as police reports, newspaper articles, etc. The people in
the Human Resources Department will assist your beneficiary with other claim filing
Denial of Claim and Appeal Procedures
If a claim is denied, you will be notified in writing of the reason for the denial. You, or
another person on your behalf, may request a review of a denied claim by writing within
60 days of receipt of the denial notice, to the CIGNA claim office that handled your
claim. This written request for review should state the reasons why you feel your claim
should not have been denied and should include any additional documentation (medical
records, etc.) which you feel supports your claim. You may also submit for consideration
additional questions or comments which you feel are appropriate, and you may review
pertinent documents. Under normal circumstances you will be notified of the final
decision within 60 days of the date your request for review is received. If there are
special circumstances requiring delay, you will be notified of the final decision no later
than 120 days after your request for review is received.
Process can be served on the Plan by directing such legal service to the Plan
Administrator, which is Trustees of Union College. Process can be served on the Plan
Administrator or CIGNA Life Insurance Company of New York, 140 E. 45th Street, New york, NY 10017-
All records for this Plan are kept on a policy year basis beginning November 1.
This booklet summarizes the benefits, terms and conditions of the Plan as fully set forth
in the master policy issued by CLICNY to Trustees of Union College. The statements
contained in this booklet are subject to the provisions of the master policy which legally
governs the operation of the Plan. The master policy as well as the annual report of the
Plan’s operations and Plan description filed with the U.S. Department of Labor, and any
other instrument under which the Plan is established or operated are available in the
Human Resources Department for review by Plan participants during normal working
hours. Upon written request to the Plan Administrator, copies of any or all these
documents will be furnished at a reasonable charge to the Plan participant.
The following statement of ERISA rights is required by federal law and regulation. As a
participant in this Plan you are entitled to certain rights and protections under the
Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all
Plan participants shall be entitled to:
a. examine, without charge, at the Plan Administrator’s office and at other specified
locations, such as work sites and union halls, all Plan documents, including
insurance contracts, collective bargaining agreements and copies of all documents
filed by the Plan with U.S. Department of Labor, such as detailed annual reports
and Plan descriptions;
b. obtain copies of all Plan documents and other Plan information upon written
request to the Plan Administrator. The Administrator may make a reasonable
charge for the copies;
c. receive a summary of each Plan’s annual financial report. The Plan Administrator
is required by law to furnish each participant with a copy of these summary
In addition to creating rights for Plan participants, ERISA imposes duties upon the people
who are responsible for the operation of the employee benefit Plan. The people who
operate your Plan, called “fiduciaries”, have a duty to do so prudently and in the interest
of you and other Plan participants. No one, including your employer, your union or any
other person, may fire you or otherwise discriminate against you in any way to prevent
you from obtaining a welfare benefit or exercising your rights under ERISA. If your
claim for a welfare benefit is denied in whole or in part, you must receive a written
explanation of the reason for the denial. You have the right to have the Plan review and
reconsider your claim.
Under ERISA, there are steps that you can take to enforce the above rights. For instance,
if you request materials from the Plan and do not receive them within 30 days, you may
file suit in a federal court. In such a case, the courts may require the Plan Administrator
to provide the materials and pay up to $100 a day until you receive the materials, unless
the materials were not sent because of reasons beyond the control of the Administrator.
If you have a claim for benefits which is denied or ignored, in whole or in part, you may
file suit in a state or federal court. If it should happen that Plan fiduciaries misuse the
Plans’ money, or if you are discriminated against for asserting your rights, you may seek
assistance from the U.S. Department of Labor, or you may file suit in a federal court.
The court decides who should pay these costs and fees. If you lose, the court may order
you to pay these costs and fees, if it finds your claim is frivolous.
If you have any questions about these Plans, you should contact the Plan Administrator.
If you have any questions about this statement or about your right under ERISA, you
should contact the nearest Area Office of the U.S. Labor-Management Service
Administration, Department of Labor.