MR.(Sanitized) CRITICISM OF BOOKLET

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP86-00964R000100110010-4
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 22
• Document Creation Date: December 14, 2016
• Document Release Date: July 23, 2003
• Sequence Number: 10
• Content Type: LIST

Approved For Relea 2003/08/13 : CIA-RDP86-0096480001001100 0011041
Page 1.
II.
Page 1.
IV.
Page 2.
C-1.
There are not 5 kinds (2 major kinds Life and Health)
or break down to 8 groups as we did.
We can't tell people which is best.
Not like NLSI. NSLI pays cash dividends. We are not
sure how-we will ours and WAEPA pays none. Further NSLI
can be converted to a permanent plan at any time. People
know about NSLI so this is not true presentation of facts.
C-2. Benefits are not "larger" unless justified by for the low
premium.
V a. Second sentence - what do they mean?
V h. Wrong statement. All are not on group basis. No Master
policy for Income Replacement, Travel-Matic, Air Trip.
Each Admian. has a copy of the Master Contracts. Why
send them to us?
Page 3. C. Absolutely wrong. To insurance companies we are Class D
If "
d-1.
risks. If they mean "our underwriters" O.K. but say so.
Wrong statement. Insurance Company does know what we do.
"
d-2.
They get .a copy of work sheet on every claim paid.
Wrong to separate WAEPA. It is as much GEHA as ABLIC.
VI.
This does not imply such.
We don't intend applications to be filled out, for-head-
quarters personnel? argwhere except our office. This says
all divisions could. We cannot operate that way. Ap-
plications must be made in our office.
n n VII. Again, why speak of WAEPA syeparately. It is a GEHA plan.
Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
 .. Approved For Release 2003/08/13: CIA-RDP86-00964R00 .-10110010-4
Page 5. (4) Wrong statement - can not, Drive; BOB; PCS only,
" (C)(1) Wrong. Applications must be filled out by our people,
in our office.
" (d) No classes. Wrong.
(f) (last sentence) I wouldntt have known this if I hadntt
read this here.
" " (g) (2) Wrong statement "any plan, other than term".
Page 7 (i) (2) Belongs under Double Indemnity.
(3) Wrong - face value is paid.
Incontestible after one year.
(4) Wrong - Our employees, as such, killed in act of war,
declared or undeclared, are covered - face value.
Page 8 (2) Wrong. Issues coverage to members of the organization.
Page 9 (e) Don't understand last sentence.
Page 10 (B) Wrong - face value is paid (1 year incontestible).
(4) Wrong. Our employees, as such, killed in act of war -
declared or undeclared are covered for face value.
-la-
Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
 . = Approved For, Relearaa 2003/08/13 : CIA-RDP86-00964R000100110010-4
_-0u office.
" " (C) (1) Wrong, A;ppUcfilled out by our people,,
(4) Wrong statement - can not. Drive; Flo
Page 10. (h)(2) Master Contract copies are available at all Admins,
" (j) Wrong. AMM& Equitable has many ways of paying
death benefits (not three),
Page 11. (2) Nothing about effective date of UBLIC.
Page 12. 14(a) Don't know when during the year it will be held.
Page 13. 6. Another fundamental statement.
13. 7(b)
" " 2.
Page 114. 1.
Page 114..14.
Wrong statement. Cost - $7.140.
Hospital Extras - unallocated has to be in. Extra
sentence is misleading.
Benefit. Wrong statement. "Cured" is only one category,
whereas there are three.
Service - Due to continued complaints and misinterpreta-
tions, the following must be added: "are only pregnancies
considered abnormal for benefit purposes."
Service 7 - Wrong statement. Has nothing to do with an
accident.
Service 9. Should be Anesthesioligist as anesthetist
under the contract may be a hospital employee,
n " Atter 10. It is mandatory that the statement "The;. maximum
allowances granted for normal maternity is hospitalization
up to 8 days at $10.00 per day and up to $20.00 for
anaesthetic." be included to prevent misinterpretation.
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 Approved For RekWe 2003/08/13 : CIA-RDP86-00964ROQ0101W00110010-4
s
Page 15. Benefit 1. Same as Page 14 - Benefit 1 "cured."
" " Service 2. Word "unallocated" should be added for clarity.
Remove last sentence under "Benefit" - misleading.
" " Benefit 7. Wrong statement - nothing to do with accident.
" " Benefit 8. Should be anaesthesiologist as anaesthetist
under the contract may be an intern.
" 16. Surgical Benefits 9(d). Master schedule is available at
all Admins. Not necessary to come to the Insurance Office.
Left out "Dental Surgical Services."
"
"
"
"
17.
"10" - Wrong - misleading.
Unvouchered -, No.
Everyone can not get blanks -
17.
11(b)
Wrong - benefits are not the same.
11
C(2)
Last sentence - what is meant?
18
(b) What about sickness with pregnancy?
it
4(c)
Wrong. You do not have to be in GEHA. You can join.
Page 19 10(a) (3) Wrong.
Page 20 d 1(b)(2) Wrong. Does not cover travel on privately owned plane.
Page 22 (g) Wrong - ? ? ?
Page 25 (2) Wrong - Not sold overseas.
it "(e)(1) Wrong. Smallpox, Encephalitis and Tetanus left out.
Page 26. Table 6 Wrong.
"
`26.
5(b) Clarify - within 3 years.
"
26.
5(c)(2) Should be spelled out as in brochure.
"
26.
5(c)4 - Transportation and ambulance should be separated.
26
5(c)7 - Refunded? Other mechanical apparatus.
"
26
5(c)8 - reimbursed?
1Apprc"d F8r.FJ fffcjqqW?/4ajC W5VQ61e8WH60W.001 00110010-4
 Approved For Release 2003/08/13 : CIA-RDP86-00964R00010011001'0-4
9
Your
A
.L.-4A A TH
L
'~mrant
e
Program
\ l(;l(N1(`I I 71(-)
Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
 Approved For-Release 2003/08/13 : ,-RDP86-00964R000100110010-4
Published in the interest of em-
ployee participation in the Organ-
izatiorn's Health Benefits and Life
Insurance program. This book-
let is for the use of employees and
their families only.
Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
 Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
CONTENTS
PACE
FOREWORD-"PLEASE READ THIS FIRST!".......... 5
HOSPITALIZATION AND SURGICAL BENEFITS PLAN
(MUTUAL OF OMAHA) 8
Eligibility ..../ ..................................... 8
Monthly Premiums ................................. 8
Coverage .......................................... 8
Hospital Service Benefits in this Country .............. 9
Hospital Service Benefits Overseas .................... 10
Surgical Benefits in this Country and Overseas ........ 12
Examples from the Schedule ........................ 12
Waiting Period ................. .................. 13
Extended Benefits .................................. 13
Payment of Insurance Benefits ...................... 13
Conversion Privilege ................... ............ 13
Application Procedures ............................. 14
SPECIFIED DISEASES POLICY (MUTUAL OF OMAHA). 15
Eligibility ......................................... 15
Dependents ....................................... 15
Premiums ......................................... 15
General Information ............................... 15
Schedule of Benefits ................................ 16
Termination ....................................... 17
Application Procedures ........... ................ 17
SPECIAL INCOME REPLACEMENT PLAN (PREFERRED
RISK) (MUTUAL OF OMAHA) .................... 18
Eligibility ......................................... 18
Schedule of Benefits and Premiums .................. 18
Accident Benefits .................................. 18
Sickness Benefits ................................... 18
Specified Aircraft Passenger Coverage ...... ......... 19
Medical Benefits for Injuries not Causing Loss of Time 19
General Provisions ................................ 19
Exclusions ....... ................................ 19
Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
 ON
UBLIC underwrites one of the GEHA-sponsored Group Term
Life Insurance policies.
The other Group Life Term Insurance policy sponsored by
GEHA requires membership in the War Agencies Employees
Protective Association (WAEPA) in addition to membership
in GEHA. This insurance is underwritten by the Equitable
Life Assurance Society of New York which is the third largest
life insurance company in this country.
BEGINNING 1 OCTOBER 1956 AND ENDING 31 OCTOBER
1956 FOR HEADQUARTERS PERSONNEL (ENDING 30
NOVEMBER 1956 FOR FIELD STATIONS), GEHA IS
OPENING ITS ROLLS FOR NEW PARTICIPANTS IN THE
MUTUAL HOSPITALIZATION AND SURGICAL BENEFITS
PROGRAM AND THE UBLIC LIFE INSURANCE PLAN
WITHOUT REGARD TO ANY PHYSICAL REQUIREMENTS
(NO HEALTH STATEMENT OR PHYSICAL EXAMINATION
NECESSARY!)
Hereafter MUTUAL Hospitalization and Surgical Benefits In-
surance will be available to new participants only during the
annual application period or within 60 days of initial entrance
on duty or return to headquarters on permanent change of sta-
tion. UBLIC Life Insurance will be available without a physi-
cal examination only during the annual application period or
within 60 days after EOD. You can get it at other times if
you pass a physical examination. The other insurance spon-
sored by GEHA is not included in the annual application pe-
riod but will continue to be available as it is now.
The rest of this booklet describes each of the GEHA-spon-
sored Health and Life Insurance benefits which are available
to you. The Insurance Branch will furnish additional infor-
mation and will assist you in your application for any of these
policies.
GEHA does not sponsor Federal Employees Group Life In-
surance since this is government-wide, is automatically ex-
tended to all eligible employees and the premiums are deducted
from your salary unless you state in writing that you do not
want it. The Casualty Affairs Branch will furnish information
and assistance about this program if you desire it.
We hope this booklet will answer your questions about your
employee insurance benefits program-Please take it home-
Study it, talk it over with your family-Be sure you have ade-
quate insurance protection for yourself and your family.
Government Employees
Health Association, Inc.
Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
 Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
HOSPITALIZATION AND SURGICAL BENEFITS PLAN HOSPITAL SERVICE BENEFITS IN THIS COUNTRY
(MUTUAL OF OMAHA) The following benefits are available under this plan with
All eligible employees, wherever located, may apply for this
hospitalization-insurance coverage for themselves and their
families during the current application period, October 1, 1956
through October 31, 1956 for headquarters personnel and
October 1, 1956 through November 30, 1956 for field stations,
or within 60 days after EOD or return from overseas (PCS)
At no other time will this coverage be available.
Hospital and Surgical Services
Single (member only) ................. $2.70
Family (member, spouse, and all children
between the ages of 14 days and 19
years) * 7.40
*Married children, regardless of age, or children insured sepa-
rately under this plan are excluded.
This plan provides hospital and surgical service benefits for
all types of illness or accident, including the following:
1. Tuberculosis
2. Heart conditions
3. Mental and nervous disorders
4. Quarantinable diseases
5. Cancer
6. Pre-existing diseases or conditions.
Neither claims which are properly payable under the Federal
Employees Compensation Act, or similar legislation, nor claims
for services other than those provided by the hospital are
covered by this contract (i.e., no coverage for special or private
nurses or doctors' calls).
coverage granted to insured members and their dependents in
any hospital in this country. This includes only those clinics
attached to a hospital.
Service Benefit
1. Hospital Room and Board: Up to $13.50 per day Room and
(Private or Semi-private Board for up to 90 continuous
Room) days with no limit on fre-
quency* (one-day return-to-
work break)-except Normal
Maternity. (See No. 3 below)
2. Hospital Extras: (unallo-
cated except for Mater-
nity) **
Up to $202.50 plus 75% of the
covered hospital extras up to
$5,000.00 of benefits.
3. Normal Maternity: (Lim-
ited)
4. Abnormal Maternity:
(Caesarean, Termination
of Ectopic Pregnancy, and
Miscarriage are only preg-
ilaial.iVJ %iiioaui.ivu wu-
normal for benefit pu-
poses)
5. Tonsillectomies and Ade-
noidectomies :
6. Out-patient Emergency
Service: (Hospital)
$10.00 per day Room and Board
up to 8 days. Up to $20.00 for
anesthetic.
Up to $13.50 per day Room and
Board for 90 days plus extras-
as paid in Nos. 1 and 2 above.
Up to $202.50 for injuries re-
quiring medical attention with-
in 24 hours of accident.
*Housewife or children discharged from hospital or by doctor as
completely cured.
**The maximum allowance granted for normal maternity is hospi-
talization up to 8 days at $10.00 per day and up to $20.00 for anesthetic.
Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
 Service
7. Out-patient Surgical
Services: (Hospital)
surgical operation where the
member is not hospital-con-
fined.
An Benefit Service
U l? o~.~8rfg rt?P9NA18/13 : CIA-RDP8 -(~d `fdQ Rs1:1 Qgj~.t' o_
cellaneous expense benefits in- cated except for matPr-
curred in connection with a nity)
8. Ambulance: Fees for transportation to and
from hospital paid under Hos-
pital Extras in No. 2 above.
(Limit $25.00)
9. Anesthesiologist: Up to $25.00 for other than
regular hospital personnel for
administration of anesthetic
paid under Hospital Extras in
No. 2 above.
10. Medical Services in Hos- Paid under Hospital Extras in
pital or authorized Clin- No. 2 above.
is : * * * (including X-ray,
laboratory tests, physical
therapy, and diagnosis)
* * *Attached to a hospital.
HOSPITAL SERVICE BENEFITS OVERSEAS
L___c., listed below are available under this plan to
The ueliefias iiawu .+v
policyholders and their dependents in any hospital they may
select outside this country.
Service Benefit
1. Hospital Room and Board: Up to $13.50 per day Room and
Private or Semi-private Board for up to 90 continuous
Maternity :
4. Abnormal Maternity:
(Caesarean, Termination
of Ectopic Pregnancy and
Miscarriage)
5. Tonsillectomies and Ade-
noidectomies :
6. Out-patient Emergency
Services: (Hospital)
7. Out-patient Surgical
Services in Hospital:
9. Anesthesiologist:
Benefit
Up to $135.00.
$10.00 per day Room and Board
up to 8 days. Up to $20.00
anesthetic.
Up to $13.50 per day Room and
Board for 90 days plus extras-
as paid in Nos. 1 and 2 above.
Paid under Nos. 1 and 2 above.
Up to $135.00 for injuries re-
quiring medical attention with-
in 24 hours of accident.
Up to $135.00 for hospital mis-
cellaneous expense benefits in-
curred in connection with a
surgical operation where the
member is not hospital-con-
fined.
Fees for transportation to and
from hospital included under
Hospital Extras in No. 2 above
(limit. $25 00).
Up to $25.00 for other than reg-
ular hospital personnel for ad-
ministration of anesthetic paid
under Hospital Extras.
Paid under Hospital Extras in
No. 2 above.
Medical Services in Hos-
pital or authorized Clin-
ics:** (including X-ray,
laboratory tests, physical
therapy, and diagnosis).
Room) days with no limit on fre- 10.
quency* (one-day return-to-
work break)-except normal
maternity (see No. 3 below).
*Housewife or children discharged from hospital or by doctor as
completely cured.
Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
* *Attached to a hospital.
 SURGICAL BENEFITS IN THI pe6RY1qqI $r LJR JTR/13 : CIA-RDP86-00964R000100110010-4
Service
Benefits for surgical service performed in a hospital, doctor's
office, or at home, listed below, are available under this plan
to members and their dependents, no matter in what part of
the world they are located. Benefits for dental surgical serv-
ices, however, are available only if they are performed in a
hospital.
Service Benefit
1. Surgical Services : Up to $250.00 paid in accord-
ance with the master schedule.
(Available for inspection.)
EXAMPLES FROM THE SCHEDULE
Hernia, unilateral ... $100.00
Hernia, bilateral 140.00
Appendectomy ...... 100.00
Radical mastectomy . 187.50
Fracture of spine .... 93.75
Hip dislocation ...... 43.75
Prostatectomy ...... 187.50
Removal of kidney ... 250.00
Removal of cataract . 187.50
Gastrectomy ...... . 250.00
Tonsillectomy and
Adenoidectomy ... 55.00
Hemorrhoidectomy .. 62.50
Hysterectomy ....... 165.00
Amputation-arm,
foot .............. 125.00
Skull fracture-com-
pound ............. $250.00
Fracture of base of spine 62.50
Bronchoscopy......... 62.50
Varicocele removal .... 62.50
Thyroid removal . 187.50
Mastoidectomy, simple . 125.00
Mastoidectomy,radical. 187.50
Normal delivery ...... 80.00
Caesarean ............ 150.00
Abdominal operation for
extra-uterine preg-
nancy .............. 150.00
Abortion or miscarriage 50.00
2. Services Related to Sur-
gery: (Anesthetist, X-ray,
Clinical laboratory)
3. Dental Surgical Services:
Paid under Hospital Extras.
(ONLY if performed in a hos-
pital or authorized clinic.)
Paid in accordance with above
schedule only if performed in a
hospital by a dentist, dental
surgeon, or an M. D.
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Plastic
Surgery: (for in-
jury incurred at any time,
except for cosmetic sur-
gery)
5. Important-Visits to doc-
tors' offices are not cov-
ered.
. uau u1 acGV1UCU1I;e W1Ln iNo. I
above.
WAITING PERIOD
No waiting period is required regardless of conditions exist-
ing prior to application.
EXTENDED BENEFITS
Benefits for hospitalization and surgery performed during
the continuance of disability are payable within thirteen/weeks
following the date such disability terminated the employment
of the member.
PAYMENT OF INSURANCE BENEFITS
The benefits provided in this plan will be paid to the insured
member upon the submission of his claim to the Insurance
Claims Office. Such claims must be substantiated by receipted
bills and nd aria .nnuo..-osis from the appropriate hospital or clinic,
doctor or dental surgeon.
CONVERSION PRIVILEGE
Upon termination of membership in GEHA by reason of
termination of employment, the insured employee may convert
his Health Insurance to an individual policy offered by the
Mutual Benefit Health and Accident Association of Omaha
without evidence of insurability, at about a 25 percent increase
in premiums, providing the employee:
(a) Is less than 75 years of age,
(b) Applies for the conversion policy within 30 days of ter-
mination of employment.
 (".1 AON
For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
This insurance may include the employee and all of his SPECIFIED DISEASES POLICY
dependents who were insured under his group certificate.
Coverage for dependent children terminates at age nineteen,
but they may apply for a conversion policy on an individual
basis.
The insurance will be effective on the date the application
and the required premium are accepted by the Company, and
will continue in force for not less than six months after the
effective date. Renewal after the first six months will be
subject to the consent of the Company.
Application for this coverage may be submitted to the Insur-
ance Branch within 60 days after an employee has entered on
duty, or within 60 days after an employee has returned-
permanent change of station-from an overseas assignment,
or on the occasion of the Annual Application Period.
Other than during the above periods NO applications will
be accepted.
(MUTUAL OF OMAHA)
All members of the Government Employees Health Associa-
tion are eligible to purchase the Specified Diseases policy which
covers poliomyelitis, leukemia, scarlet fever, diphtheria, small-
pox, spinal or cerebral meningitis, encephalitis, tetanus, or
rabies. If the applicant is not already a member of GEHA, a
one-dollar membership fee will be charged. This insurance is
effective when the condition first manifests itself more than
15 days after the policy date; i.e., the day application is made.
Eligible dependents shall include the wife or husband of the
protected person and the insured's unmarried children under
21 years of age. This does not include, of course, dependents
who are protected by the same underwriter as policyholders
themselves.
After the insured has one or more of his eligible dependents
insured, each additional eligible dependent shall become auto-
matically insured on the date such additional dependent is
acquired.
Protected person only (single) ............. $4.00 per year
Protected person with dependents (family) .. 10.00 per year
The policy is renewable on the anniversary date each year,
December 1.
If the insured or a dependent shall become afflicted with
definitely diagnosed poliomyelitis, 'leukemia, scarlet fever,
diphtheria, smallpox, spinal or cerebral meningitis, encepha-
litis, tetanus, or rabies (including inoculations for suspected
rabies), which first manifests itself and requires treatment
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 Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
beginning while the policyholder or his dependent is insured, TERMINATION
the Company will pay benefits, as outlined in the following
Schedule of Benefits, for the expense actually incurred therefor
within three years after the date of the first treatment, but not
to exceed in the aggregate, $5,000 for each incidence of each
such disease. Benefits under this insurance are in addition to
benefits under the Mutual Hospitalization and Surgical Bene-
fits insurance.
SCHEDULE OF BENEFITS
1. Doctor bills.-The charges made by legally qualified
physicians or surgeons for treatment (including charges for
treatment by osteopaths or physiotherapists).
2. Hospital bills.-The charges made by the hospital for
room and board, all service of regular hospital attendants, and
any hospital apparatus or medicines used in the treatment.
3. Special nurse.-The charges made for the services of a
registered, graduate nurse or nurses (relative or member of
family excluded).
4. Ambulance.-The charges made by the ambulance com-
pany for transporting the afflicted person in an ambulance to
or from a hospital or to a railroad station or airport for trans-
portation covered in item 10 of this schedule.
5. X-ray and laboratory.-The charges made for X-ray and
v _ , ?
A.-lay laboratory aer Y1l.G.
6. Drugs and medicines.-The charges made for .all drugs
and medicines used in the treatment of the disease.
7. Iron lung.-The charges made for the rental of an iron
lung or similar mechanical apparatus.
8. Wheelchair.-The charges made for the rental of a wheel-
chair.
9. Braces and crutches.-The charges made for braces and
crutches as are deemed necessary by the attending physician
for the treatment of the disease.
10. Transportation.-The charges made for transportation
by aircraft or railroad, if in the opinion of the attending physi-
cian it is necessary to transport the afflicted person to another
locality for treatment.
This coverage will cease if the protected person ceases to
pay the renewal premium when due or upon termination of his
employment with us. Termination of employment shall be
defined ' as cessation of active work by reason of resignation,
dismissal or being pensioned or retired.
If at the time of termination of insurance a protected person
or dependent is receiving benefits in accordance with the policy,
such benefits will continue to be paid for the balance of the
period for which he would otherwise have been entitled to such
benefits.
Applications for this policy must be accompanied by the
payment of an annual premium ($4.00 or $10.00) plus a one-
dollar membership fee, if not already a member of GEHA.
Check must be made payable to "GEHA-Inc." Inasmuch as
the renewal date of the Master Contract is December 1 each
year, applicants obtaining this coverage effective on the first
of any month other than December will pay a proportionate
premium to carry it to December and from then on the pre-
mium will be as stated above. The following table illustrates
these fractional payments :
Month Applying for Insurance
Last Month Paid
Months
Family
Single
Oct . ..............
1
$0.83
$0.33
Sept. ...... . ......
2
1.66
.67
Aug . ..............
3
2.50
1.00
July ..............
4
3.33
1.33
June .............
5
4.17
1.67
May ..............
6
5.00
2.00
April .............
7
5.83
2.33
March ............
8
6.67
2.67
Feb. ..............
9
7.50
3.00
Jan . ..............
10
8.33
3.33
Dec . ..............
11
9.16
3.67
Nov . ..............
12
10.00
4.00
Approved For Release 2003/08/13 CIA-RDP86-00964R000100110010-4
 Approved For Release 2003/08/13 : CIA-RDP86-00964R000100110010-4
SPECIAL INCOME REPLACEMENT PLAN SPECIFIED AIRCRAFT PASSENGER COVERAGE
(PREFERRED RISK)
(MUTUAL OF OMAHA)
ELIGIBILITY
This special plan is offered to preferred risks only and
is therefore limited to members who have no disqualifying
physical impairments and are working full time. Eligible
members may enroll in any of the plans offered up to age 68.
A $1.00 membership fee will be required when the applicant is
not already a member of GEHA.
SCHEDULE OF BENEFITS & PREMIUMS
Weekly
Benefit
Annual
Premium
Semiannual
Premium
Class 1 .... $25.00 $25.70
None
Class 2 ....
50.00
51.35
$25.70
Class 3 ....
75.00
77.05
38.55
Class 4
100.00
102.70
51.35
ACCIDENT BENEFITS
Weekly benefits resulting from total disability as a result of
accident are paid beginning with the 91st day after the accident
and for as long as total disability exists-even for life. Weekly
benefits for partial disability resulting from accidents are paid
commencing with the 91st day of disability and continuing for
a period as long as 13 weeks. The rate of this benefit for
partial disability will be one-half the weekly benefit.
SICKNESS BENEFITS
Weekly benefits for total disability as a result of sickness
will be paid commencing with the 91st day of disability and
continuing for as long as 10 years.
This policy covers injuries received as a result of riding in
an aircraft only if the insured member, as a passenger, is
boarding, riding in, or alighting from a licensed passenger air-
craft provided by a common carrier of passengers and operated
by a licensed transport pilot upon a regularly scheduled pas-
senger route between definitely established airports.
MEDICAL BENEFITS FOR INJURIES NOT CAUSING LOSS
OF TIME
Without regard to the 90-day qualification mentioned above,
expenses actually incurred by the insured member for treat-
ment of injuries by a legally qualified physician will be paid.
This payment will not exceed the amount of one weekly pay-
ment for any one accident.
GENERAL PROVISIONS
All disabilities arising after the insurance is effective are
covered, irrespective of date of origin of the ailment causing
such disabilities. No rider may be applied at any time now
or later.
A waiver of premiums becomes effective after six months
of continuous disability providing policy is then in force. This
means that no further payment of premiums is necessary so
long as the disability exists.
This contract provides for a 31-day grace period for pay-
ment of any renewal premium.
This policy does not cover: (a) Any loss caused by war or
any act of war or loss incurred while engaged in military,
naval, or air service; (b) injuries received as a result of riding
in an aircraft except as a passenger; (c) pregnancy, miscar-
riage or childbirth, or suicide, sane or insane.
CONVERSION PRIVILEGES-NONE
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This coverage will cease if the insured member fails to pay
the renewal premium when due, or terminates his employment
with us. Termination of employment shall be defined as
cessation of active work by reason of resignation, dismissal, or
being pensioned or retired.
Applications for this policy must be accompanied by an an-
nual premium or semiannual premium on all plans except
Plan 1, which requires an annual premium. In addition, as
mentioned above, a $1.00 membership fee should be included
if the applicant is not already a member of GEHA. Checks
must be made payable to "GEHA-Inc."
The Association reserves the right to require a report of
medical examination if the statements on the initial applica-
tion so warrant. However, employees stationed overseas when
applying must submit a report of physical examination per-
formed either by Organization doctors or private physicians,
at the employee's expense.
LIFE INSURANCE PLANS
UNITED BENEFIT LIFE (UBLIC)
Accidental Monthly
Class Face Amount Death Benefit Premium
Class 1 ........... $3,000. . plus... $3,000.......... $1.83
Class 2 ........... 6,000 plus 6,000.......... 3.66
Class 3 ........... 9,000... plus... 9,000 .......... 5.49
Class 4 ........... 12,000... plus. . . 12,000 .......... 7.32
Class 5 15,000... plus ... 15,000 .......... 9.15
by members of GEHA:
ELIGIBILITY
All persons who are already members of the Government
Employees Health Association in good standing, or who have
paid their one-dollar membership fee may purchase this life
insurance, provided they have not yet reached their sixtieth
birthday. This protection may be continued on the group
basis until the insured attains age 65, at which time the face
amount of the contract as well as the accidental-death cover-
age will be reduced to one-half (50 percent) of the previous
amount, with the premiums also being reduced 50 percent.
The insured may retain this coverage as long as he remains
with the Organization.
Detailed military personnel on active duty, who meet the
above age requirements, are eligible to purchase life insurance,
thereby becoming members of GEHA with the payment of
their membership fee. Military members may retain their
insurance for the full duration of their membership in the
Association. This same opportunity is afforded detailed civilian
personnel.
The death of any member of GEHA who is or becomes a
member of the military services of this or any other country,
which results from an Act of War, whether declared or unde-
clared, is not covered under this contract.
SCHEDULE OF BENEFITS AND MONTHLY PREMIUMS
The following schedule illustrates the face amounts of life
insurance, accidental death benefits, and monthly premium
rates for the five classes of coverage which may be selected
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/0111
A member may apply for an increase in his life insurance
coverage, that is change to a higher class, at any time, pro-
vided he furnishes the Association satisfactory evidence of
insurability by a report of medical examination. This may
be accomplished by a report of examination from a private
physician on forms supplied by GEHA. The resulting report
must be submitted to the Association for final approval.
A member may change to a lower class of life insurance
coverage ONLY if he has continued his current coverage for
a period of 12 or more continuous months.
PREMIUM WAIVER FOR TOTAL AND PERMANENT
DISABILITY
In the event a policyholder becomes totally and, presumably,
permanently disabled prior to reaching the age of 60, his insur-
ance will remain in force without payment of premium until
recovery or death, regardless of age.
A double indemnity provision covering death from accidental
causes is automatically included as a basic part of the contract.
T +t-.LLG .. member
JJG ..t- loss of iLLLG , ite
1111m) insures L L1CL.U against resulting ULLCI:kIy,
and independently of all other causes, from bodily injuries pro-
duced solely through accidental means.
In the event a policyholder is injured through purely acci-
dental "means, and dies within 90 days from the date of the
accident, the underwriters will pay to the beneficiary the
amount shown in the following schedule, in addition to the
face value:
The accidental death benefit does not cover death caused
directly or indirectly, wholly or partly:
(a) By bacterial infections (except pyogenic infections
which shall occur with and through an accidental cut
or wound), or
(b) By any kind of disease, or
(c) By medical or surgical treatment (except such as may
result directly from such treatment made necessary by
injuries covered by this policy), nor shall it cover
(d) Suicide or any attempt thereat, while sane or insane, nor
(e) Death from any injuries sustained as the result of or
while participating in aeronautics, aviation, air travel
or air transportation, except as a passenger. The term
"passenger" is understood to exclude pilot, copilot, and
all other members of the crew engaged in the operation
of the aircraft, nor
(f) Death after any premium has been waived.
PAYMENT OF INSURANCE BENEFITS
The beneficiary may elect to have the death benefit paid as
follows:
(a) In a lump sum, or
(b) In a series of monthly installments, or
(c) Partly in a lump sum and the balance in a series of
monthly installments.
The beneficiary may be changed at any time upon the
Class I ...............
$3,000
written request of the policyholder.
Class II ...............
6,000
Class III . ..............
9,000
CONTINUATION OF INSURANCE UPON TERMINATION OF
Class IV ..............
12,000
EMPLOYMENT (GRACE PERIOD)
Class V ...............
15,000
The life insurance protection will continue in effect for 31
days following termination of employment.
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CONVERSION PRIVILEGE of the first two months' premium and, where required, the
A policyholder may convert his life insurance to any one of
the permanent plans of life insurance, other than term (20-
Payment life, Ordinary life, Endowment, etc.) underwritten by
the United Benefit Life Insurance Company, without a report
of physical examination, upon reaching age 65 or within 31
days from the date of the termination of his employment.
Necessary forms will be supplied and arrangements made for
such conversion by this Association upon application of the
insured for same.
APPLICATION PROCEDURES AND MEDICAL
EXAMINATIONS
Applications for this life insurance will be permitted during
the Annual Application Period, during which time it will not
be necessary to meet any requirements regarding physical con-
dition, such as a health statement or report of medical exami-
nation by a doctor. This is true also in the case of new em-
ployees making application within 60 days after entry on duty.
At any other time a complete satisfactory report of medical
examination must be submitted to the Insurance Branch,
together with the application.
Applications for membership in the Government Employees
Health Association, Inc. may be submitted to the Insurance
Branch within 60 days after an employee has entered on duty,
or on the occasion of the Annual Application Period. The cur-
rent Application Period extends from 1 October 1956 through
31 October 1956 for headquarters personnel and from 1 Octo-
ber 1956 through 30 November 1956 for overseas personnel.
The life insurance becomes effective the day the application
is received in and payment made to the Insurance Branch, or
in the case of overseas applications, the day the application
is certified to by an authorized person.
Employees who are currently members of the Association,
by reason of their already having some other GEHA coverage
(hospitalization, etc.) may obtain life insurance without the
payment of an additional membership fee. Applications for
this life insurance coverage must be accompanied by payment
membership fee in the Association. Checks in payment of
premiums should be made payable to "GEHA-Inc."
WAEPA-LIFE INSURANCE
(EQUITABLE LIFE ASSURANCE SOCIETY OF NEW YORK)
Employees are eligible for membership and insurance pro-
tection under this contract if they fall into one of the follow-
ing categories:
(a) A government employee who is a citizen of our country
now outside continental limits of the country, wherever
domiciled;
(b) A government employee located in this country now in
training for duties abroad, or awaiting transportation;
(c) A supervisory or administrative employee located in this
country if, in the normal course of duty, required to
111 LL11G Ul..LpO Q,UI UGLL1,
(d) A director of training programs for employees fitting
the above descriptions.
Detailed military personnel are not eligible to purchase this
coverage.
The following table illustrates the face amounts of life in-
surance, accidental death benefits, and premium rates for the
two amounts of coverage which may be purchased by members
of GEHA.
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Amt.
of
Group
Life
Acci-
dental
Death
and
Dis-
Total
*Cost
Qtrly.
Annual
Insur-
member-
Cover-
per
Pre-
Pre-
Age Group Basic Salary ance
ment
age
Mo.
mium
mium
Up to 40 incl. Less than $3,200 $7,500
$12,500
$20,000
$4.17
$12.50
$50.00
$3,200 and over 15,000
25,000
40,000
8.33
25.00
100.00
41-50 incl... Less than $3,200 7,500
12,500
20,000
5.21
15.63
62.50
$3,200 and over 15,000
25,000
40,000
10.42
31.25
125.00
51 to 65 years Lessthan$3,200 7,500
12,500
20,000
6.25
18.75
75.00
$3,200 and over 15,000
25,000
40,000
12.50
37.50
150.00
*In addition an initial $2.00 membership fee is required by WAEPA.
Rates automatically increase when insured attains the next
age grouping under our graded premium plan.
This accidental death provision does not cover : (1) Loss re-
sulting from bacterial infections except pyogenic infections
caused wholly by injury, or (2) Loss resulting from medical or
surgical treatment except that made necessary solely by injury,
or (3) Loss resulting from suicide or any attempt thereat,
while sane or insane, or (4) Loss resulting from injury sus-
tninprl mhiip in nr nn nnv vphirlp nr ripvirp fnr aprial naviaa-
tion, except as a passenger in a previously tested and approved
aircraft, other than experimental or prototype aircraft.
TERMINATION AND CONVERSION RIGHTS
Insurance may be discontinued at any time by resignation
from the Association. Coverage also terminates upon separa-
tion from the government service, for nonpayment of premiums
or entry into the armed forces of any country.
This life insurance automatically terminates 31 days after
termination of membership which coincides with the last day
of active employment with the government, not including ter-
minal leave. Provided application is made to the Equitable
Life Assurance Society in writing within 31 days after termina-
tion of active employment, a policy of life insurance in any of
the forms issued by the Society (except Term Insurance) may
be issued, in amount equal to or less than that held as a
member of GEHA.
PAYMENT OF INSURANCE BENEFITS
A choice exists at the time of a claim so that the beneficiary
may choose to receive the benefit payments in a lump sum
or installments from the Equitable Life Assurance Society.
Application for this coverage may be submitted at any time,
if eligibility requirements are met. WAEPA insurance is not
included in the annual GEHA Application Period.
The application, together with a two-dollar ($2.00) WAEPA
membership fee, and at least two monthly premiums must be
submitted to the Insurance Branch. The Employee's State-
ment of Health on the reverse of the application must be com-
pleted in detail. The underwriter reserves the right to request
a satisfactory report of medical examination where deemed
necessary, prior to final acceptance of the application.
The life insurance becomes effective the day the application
is received in and payment made to the Insurance Branch or,
in the case of overseas applications. the day the application is
certified to by an authorized person. Checks in payment of
premiums shall be made payable to "GEHA-Inc."
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TRAVEL INSURANCE
"TRAVEL-MATIC"
(MUTUAL OF OMAHA)
GENERAL INFORMATION
This special contract provides for $25,000 to $50,000 cash
benefits for accidental death on any common carrier of pas-
sengers plus certain medical benefits as specified below.
This covers the insured regardless of where he travels : Across
town, across country, or across the ocean, for business or pleas-
ure. The TRAVEL-MATIC automatically furnishes protection
to the insured as a passenger upon boarding any public trans-
portation vehicle. This coverage also includes travel while a
passenger on planes operated for or by the Military Air
Transport Service.
There are no issuing age limits in connection with the
issuance of a TRAVEL-MATIC policy.
The policy will be issued only in those amounts specified in
the Schedule of Benefits and Rates. The minimum amount is
$25,000 and the maximum amount $50,000. A person who
carries other common-carrier travel accident coverage under-
written by MUTUAL of Omaha may not be issued a TRAVEL-
MATIC policy with the $50;000 maximum amount, but only the
difference between this $50,000 and the amount of such cover-
age he already carries.
There are no benefit riders that may be attached to this
policy.
This policy will be sold only on an annual basis.
1. Accidental Death and Dismemberment Benefit-Principal
Sum payable for loss of life or for double limb or eye loss;. one-
half Principal Sum for single limb or eye loss.
2. Medical expense benefit for covered injuries requiring sur-
gical treatment, hospital care and services, nurse, X-ray exami-
nation, and ambulance service but not to exceed, in the ag-
gregate, $50.00 for each $1,000.00 of Principal Sum for any one
accident.
3. Exposure and Disappearance Provision-Regular benefits
are payable if the insured suffers loss due to exposure. In ad-
dition, loss of life benefits will be paid if the insured has not
been found within one year following a covered accident.
4. Principal Sum increases 5 percent for each 12-month
period policy is in force, but the Principal Sum may not be in-
creased by more than a total of 25 percent.
LIMITATIONS
1. Excludes loss caused by war, acts of war, or suicide.
2. For the purposes of this policy, nonscheduled airlines are
considered common carriers, so long as the planes carry certifi-
cates of air-worthiness issued by the appropri to +L