Masonry Magazine October 1978 Page. 12
Accidents Do Happen...
Protect yourself at work or at home with:
Accidental Death & Dismemberment Insurance
LOW-GROUP PREMIUMS
FOR YOU
$21.00 A YEAR
FOR $25,000
OR
FOR YOUR FAMILY
$31.25 A YEAR
FOR $25,000
NO HAZARDOUS WORK EXCLUSIONS
This is not just a "Travel Plan". Naturally it does cover you when you're traveling for work or pleasure...but more importantly, you are also covered at home, at work, anywhere. 24 hours a day. 365 days a year. All over the world.
ELIGIBILITY
Members age 70 and under are eligible for this coverage. If you choose the Family Plan, the one cost provides coverage for yourself, your spouse, and all unmarried dependent children (no matter how many) between the ages of birth and 19 years (through 22 years if a full-time student at an accredited college or university).
FAMILY PLAN
This plan provides coverage for you and your eligible dependents as follows:
(a) You are insured for 100% of your Principal Sum...up to $150,000.
(b) If you have no dependent children your spouse will be insured for 50% of your Principal Sum... up to $50,000.
(c) If you do have dependent children, your spouse will be insured for 40% of your Principal Sum... up to $40,000.
(d) Each dependent child will be insured for 10% of your Principal Sum... up to $10,000.
HOW BENEFITS ARE PAYABLE
The benefit amount is payable for accidental loss of life, two limbs or the sight of both eyes (or one limb and the sight of one eye). One-half the benefit is payable for loss of one limb or the sight of one eye. In the event of multiple injuries to an insured person, only one amount is payable... the largest applicable.
3 WAY PROTECTION
For loss of Life, Sight or Limb
up to $150,000 paid for loss of life.
up to $150,000 paid for loss of both hands or both feet, or loss of the sight of both eyes, or loss of one foot and one hand, or one foot and sight of one eye, or one hand and sight of one eye.
up to $75,000 paid for loss of one foot, or one hand or loss of sight of one eye.
EXCLUSIONS
The policy does not cover loss caused by or resulting directly or indirectly from any one or more of the following: (1) suicide or self-destruction or any attempt thereat. while sane or insane; (2) bodily informity, sickness or disease; (3) medical or surgical treatment (except medical surgical treatment made necessary solely by injury): (4) declared or undeclared war or any act thereof: (5) accidents occuring while serving on active duty in any type of Military Services of any country or international authority: (6) Private flying, Military flying and flying as a pilot or crew member.
RENEWAL PROVISION... FOR LIFE
As long as the Master Policy remains in effect, you may continue to renew your coverage for life. Your insurance will continue for life, unless one of the following occurs: (1) The Master Policy terminates: (2) The member or dependent ceases to be eligible as defined; (3) You fail to pay your premium.
HOW TO APPLY
1. Complete, date and sign the application form.
2. Mail along with your check or money order for your first annual premium.
Make checks payable to:
James Group Service, Inc.
230 West Monroe Street Chicago, Illinois 60606
Underwritten by:
Bankers Life and Casualty Company, Chicago, Illinois
Complete details of this program are outlined in the certificate and master policy
Select Your Plan Up To $150,000
| Principal Sum | INDIVIDUAL PLAN | FAMILY PLAN |
| ----------- | ----------- | ----------- |
| $ 25,000 | $21.00 | $ 31.25 |
| $ 50,000 | 41.00 | 61.50 |
| $ 75,000 | 61.00 | 91.75 |
| $100,000 | 81.00 | 122.00 |
| $150,000 | 121.00 | 182.50 |
Principal Sum reduces to $10,000 at age 70.
...tear here and mail today...
ORGANIZATION:
MCAA (10/78) CERT. NO.
POLICYHOLDER:
Professional Association and
Organization Insurance Trust
Policy Aggregate Limit is $1.000.000 per Aircraft
MASON CONTRACTORS ASSOCIATION OF AMERICA
Policy Number SR 83.010-3
Issued Effective
For Bankers Life and Casualty Company Use Only.
APPLICATION is hereby made to the Bankers Life and Casualty Company for accident insurance as follows: (Please print or type)
1. Full Name:
2. Date of Birth
3. Occupation.
4. Address:
(Street)
(City)
(State)
(Zip)
5. Beneficiary:
Relationship:
6. Indicate your Amount of Insurance $25,000 $50,000 $75,000 $100,000 $150,000
7. Check
One Plan
Individual Only Family Plan
Under the Family Plan the employee is the beneficiary of the Spouse and of all eligible children.
Signature of Applicant X
Date of Application.
12 MASONRY/OCTOBER, 1978