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Accident and Sickness

STATE OF FLORIDA

CAMP COVERAGE

Provided By:

ACE American Insurance Company

This insurance is purchased and administered by the Department of Management Services, Division of State Purchasing. The outline of coverage shown below is provided as an overview; please refer to the insurance policy for specific information. All questions relating to this policy should be directed to State Purchasing at (850) 487-0417 or Suncom 277-0417.

POLICY INTENT: To provide benefits, as described below, for sponsored camps or activities. All camps or activities must have a director or person who is in charge of the facility and/or activities, have organized activities/programs, and must be registered to participate.

INSURED PERSON: Any person who is enrolled as a camper or participant, as listed on the camp application, and for whom a premium has been paid.

THIS POLICY WILL COVER: Any unexpected or unforeseen occurrence which results in bodily injury to an Insured Person.

DESCRIPTION OF COVERED ACTIVITES: While traveling directly, without interruption, to or from an organized activity or program, and while participating in any regularly scheduled and supervised activity.

MEDICAL BENEFITS:

Accidental Death and Dismemberment Benefit $15,000 per Accident

Accident Medical Benefit $25,000 per Accident

Dental Expense Benefit $250.00 per Tooth; $1,000 per Accident

*Sickness Medical Expense Benefit $2,500 per Sickness

*This is an optional benefit, separate rates apply.

DEDUCTIBLES: None

RATES (daily, per person):

	Day/Overnight	Sports
Plan A (Primary, without Sickness)	$0.25	$0.45
Plan B (Excess, without Sickness)	$0.20	$0.30
Plan C (Primary, with Sickness)	$0.60	$0.95
Plan D (Excess, with Sickness)	$0.45	$0.70

EXCLUSIONS:

Listed below are some of the common exclusions that apply to this coverage; please refer to the policy for a list of all exclusions. There is NO coverage for losses resulting from:

1. Self-inflicted injury.

2. Psychological or psychiatric counseling.

3. Injury due to use of alcohol or drugs.

4. Pregnancy or child birth.

5. While traveling in or on a two or three-wheeled motor vehicle.

6. Pre-existing conditions.

7. Injury from riding, boarding, or alighting from any aircraft, except in a regularly scheduled licensed aircraft.

AGENT: Insurance Office of America serves as the agent for this policy. Please direct all inquiries to:

Jennifer Harris

Agent In-Charge

407-998-5489

Jennifer.Harris@ioausa.com