Masonry Magazine September 1967 Page. 8
Don't Pass Up This Opportunity! Enroll in our new, low-cost Hospital Money Plan
EXCLUSIVELY FOR MCAA MEMBERS
Here is the ideal Plan not only for MCAA members, chapter associate members and exhibitors, but their families as well. Plan supplements any existing insurance with few limitations. Upon payment of semi-annual premium, coverage starts immediately. Protection is world-wide and around the clock. During this enrollment period applicants will be insured regardless of present health condition. Don't pass up this opportunity!
These outstanding features:
* DAILY HOSPITAL CASH IS YOURS up to 500 days. That's $15,000 worth of coverage for insured member or employee.
* POLICY CANNOT BE CANCELLED or reduced if required premium paid up to 65th birthday.
* PLAN PAYS IN ADDITION to Workmen's Compensation insurance you may carry.
* BENEFITS BEGIN with the first day of confinement.
(See policy for complete provisions.)
MCAA Family Hospital Money Plan is administered by Fred S. James & Co. and underwritten by Fireman's Fund Insurance Company. Make checks payable to Mason Contractors Assn. of America, 208 South LaSalle Street, Chicago, Illinois 60604. If you desire further information phone 726-5742.
ACT NOW . . . TIME IS LIMITED . . . MAIL THIS APPLICATION TODAY!
MASON CONTRACTORS ASSOCIATION OF AMERICA
Application For Hospital Money Coverage
(Please Print)
Your Name
Address
Birthdate
Month
Day
Year
Your Employer's Name.
Address
1. Have you (or any eligible dependents, if you are applying for dependent coverage) had any medical or surgical advice or treatment in the past 5 years? If "yes," state name of person, ailment, date and duration and results.
2. To the best of your knowledge and belief, are you (and each eligible dependent, if you are applying for dependent coverage) now in good health and free of any physical impairment or disease? If "no," state full particulars and name of person information pertains to.
3. Do you certify that you are actively employed or actively self-employed, on a full-time basis?
4. Do you understand and agree that any condition for which you or any eligible dependent received medical treatment or advice within 12 months prior to your effective date of insurance will not be covered until 12 consecutive insured months have passed without medical treatment or advice for such condition?
This Application constitutes a part of the insurance contract. Your insurance coverage is afforded in consideration of your answers being true and correct. You will receive a Certificate of Insurance prior to your effective date of coverage.
Date
X
Signature of Member
FIREMAN'S FUND INSURANCE COMPANY
CIRCLE SEMI-ANNUAL PREMIUM RATE
APPLICABLE FOR YOUR AGE AND FAMILY STATUS
All premiums apply at member's or employee's (Insured's) age and attained age on annual renewal date.
Your
Age
Under 40
40 but
Insured,
Insured Spouse
Male Female Insured Child Child
Insured Insured Spouse (ren) (ren)
$18.00 $30.00 $39.00 $31.00 $52.00
under 50 24.00 36.00 49.00 36.00 61.00
50 but
under 60 33.00 45.00 64.00 44.00 75.00
60 but
under 64 48.00 57.00 88.00 58.00 98.00
Eligible Dependents-Spouse under 64 years of age and unmarried children from 14 days to 19 years (to 23 years if full-time students fully dependent upon the Insured).
masonry September, 1967