Hospital Accident Protection Program - Our Credit Union

Affinion Benefits Group 400 Duke Drive Franklin, TN 37067?2700

Allied Solutions 1320 City Center Drive, Ste. 300 Carmel, IN 46032

Hospital Accident Protection Program

Training Kit

August 2017 OUR Credit Union

Key Contacts

Chris Lambert

Phone: (800) 826.9384 x10507 Fax: 317.428.5404

chris.lambert@

Hospital Accident Protection Program

Your marketing event is scheduled to be mailed the week of:

08/18/2017

The marketing creatives that are mailed to Members have been previously approved by the client, insurance carrier, and Affinion Benefits Group.

Your Members will receive marketing, policy information, and an activation form.

Interested Members select insurance coverage, designate beneficiary, sign, and return the activation form to Affinion Benefits Group. Received activation forms are processed for the coverage level selected.

Monthly Rates are $17.65 for Single Coverage and $29.95 for Family Coverage.

Affinion Benefits Group sends a customized fulfillment kit with program details including premium, coverage amount, bill date, and effective date. A Certificate of Insurance will be mailed 30 days prior to the Members coverage effective date.

Paying insureds are billed according to the premium rate schedule listed in the Certificate of Insurance. Hospital Accident Protection (HAP) is a monthly billed product.

Affinion Benefits Group services Member requests throughout the lifetime of their coverage. Members may call Affinion Customer Service at (877) 309.6576.

OEB3HCTP R0517

CARDSENCLOSED

SAMPLE SAMPLE:

You can collect up to

$1,800 A DAY

in cash for a covered hospital stay -- to spend any way you want.

This money will be PAID DIRECTLY TO SAMPLE SAMPLE

CASH BENEFITS PLAN

HOSPITAL ACCIDENT INSURANCE PLAN

SAMPLE SAMPLE SAMPLE SAMPLE 123 ANYNICE STREET ANYTOWN, US 00000

$1,800.00 a day

Intensive Care Confinement

Limit per occurrence:

$657,000.00 for 365 days

$900.00 a day

Hospital

Confinement

Limit per occurrence:

$328,500.00 for 365 days

1 MAIL THIS FORM WITHIN 14 DAYS

USE YOUR CASH BENEFITS AS YOU SEE FIT. It's your money. The Hospital Accident Insurance Plan pays in addition to other benefits you may receive from other plans. You are guaranteed acceptance by Federal Insurance Company as a member of OUR Credit Union age 18 or older. And you get our 60-Day, 100% Money-Back Guarantee.1

$450.00 per accident

Emergency Room

Treatment

As a valued member, you are eligible to receive the protection of the Hospital Accident Insurance Plan -- at group rates for OUR Credit Union members. ? Checks are sent directly to you or anyone you choose ? You choose the hospital ? No medical exam or health questions ? Coverage goes with you anywhere in the world.

All benefit checks will be made out in your name so you can use them however you wish -- to pay bills, day-to-day expenses, or to make up for lost wages. Or you may prefer to just deposit them in your credit union for future use -- it's totally your choice.

Remember, you cannot be turned down for this important coverage, and it pays in addition to any other insurance you may have. What's more, because this coverage is yours with a 100% Money-Back Guarantee, you'll be protected even while you take your time reviewing it for 60 days.1

Cash Benefits Plan

133333333331 SAMPL2 3WX1Q42 S S

I want Hospital Accident Insurance that pays up to $1,800.00/day intensive care; up to $900.00/day hospital stay; $450.00 per accident for emergency room expenses.

2

I select the following plan:

When neither box is selected, you will receive single coverage. Please check one:

Single (Covers you)

MONTHLY GROUP RATES 60-Day, 100% Money-Back Guarantee1

Family (Covers you, your spouse/domestic partner, and/or eligible dependent children)

Best Plan Family: $29.95 Single: $17.65

3

SEND NO MONEY NOW. Charge Authorization: Yes. Please sign me up for this insurance. I have received and read all insurance disclosures for the Hospital

Accident Insurance Plan. I authorize my financial institution and its service provider to automatically charge my account

issued by the financial institution named above monthly according to the rate schedule for the coverage I select. I understand that I can

cancel my coverage at any time by notifying the plan administrator in writing and that my coverage will end at my next billing date.

SIGN HERE

Must be signed by one of the addressees above.

Date

For joint accounts, signator will be primary insured person. Must be age 18 or older. Confinement benefits reduce by 50% at age 65, and reduce to 25% at age 75. Outpatient Emergency Room benefits do not reduce due to age. 1If you are not happy with the insurance for any reason, and you have not submitted a claim that has been or will be paid, simply contact us within the first 60 days of enrollment for a complete refund of your premium and the coverage will be cancelled back to its effective date. Robert J. Dudacek, Licensed Agent #972576 ? 2009 Affinion Group Hospital Accident Insurance is underwritten by Federal Insurance Company.

Return this entire form in the enclosed postage-paid envelope

Underwritten by Federal Insurance Company, a Chubb company.

A96167A APCUHCDTP (R1/17)

W-96167-A

2D BARCODE

In an emergency, you'll want to be carrying this card, and you'll want a loved one to carry it, too.

Punch out the cards below. Keep one card in your wallet and give one to a family member. They are yours to keep as a valued OUR Credit Union member.

Prepared exclusively for: Sample Sampleman, 123 Any Street Any Street Any Street Any Street, Any Town, USA

CDCUHCLTP (R12/16)

$1,800.00 a day cash benefit for up to 365 days of intensive care

$900.00 a day cash benefit

for up to 365 days of hospital confinement Pre-Approved Hospital Accident Insurance Plan

Hospital Cash Benefits

$1,800.00 a day cash benefit for up to 365 days of intensive care

$900.00 a day cash benefit

for up to 365 days of hospital confinement Pre-Approved Hospital Accident Insurance Plan

Hospital Cash Benefits

NAME: S. Sampleman

Any Town, State, Zip

Coverage begins upon receipt of your signed Activation Form. This card is not proof of insurance.

NAME: S. Sampleman

Any Town, State, Zip

Coverage begins upon receipt of your signed Activation Form. This card is not proof of insurance.

82379040000 843723920 - 38373627300000000

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