Masonry Magazine March 1972 Page. 33
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 associates and exhibitors, but their families as well. Plan supplements any existing insurance with few limitations.
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.
PAYS MONEY TO YOU FOR EVERY FULL DAY you or your insured dependent spends in a hospital while under 65 years of age up to 500 days for each accident or sickness as follows:
Hospital confinement of insured..$30.00 per day
Hospital confinement of spouse... $20.00 per day
Hospital confinement of child....$10.00 per day
(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 check payable to Fred S. James & Co., One North La Salle Street, Chicago, Illinois 60602. If you desire further information telephone: a/c 312 346-3000.
ACT NOW
TIME IS LIMITED. MAIL THIS APPLICATION TODAY!
(You will be notified of coverage effective date.)
(Please Print)
Your Name
Address
Birthdate
Month
Your Employer's Name.
MASON CONTRACTORS ASSOCIATION OF AMERICA
Application For Hospital Money Coverage
Day
Year
Address
1. Have you for 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?
CIRCLE SEMI-ANNUAL PREMIUM RATE APPLICABLE FOR YOUR AGE AND FAMILY STATUS
Your Age | Insured | Insured Spouse | Insured + 1 Child | Insured + Spouse | + Child(ren)
------- | -------- | -------- | -------- | -------- | --------
Under 40 | $18.00 | $30.00 | $39.00 | $31.00 | $52.00
40 but 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.
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
Effective June 1, 1989, a medical condition shall no longer be considered "pre-existing" after (1) 12 consecutive months Insurance without medical treatment or consultation for such condition or (2) the insured person has been covered by this insurence for 24 consecutive months, whichever first accus.