Claim Information:

To access claim forms for your Accident, Critical Illness, Disability or Hospital Indemnity plan - Please click on the link below:

www.reliancestandard.com/teamsters1932


Pay by List Bill Invoice
List Bill

Vision
Vision - Plan 1
Vision Plan - 1
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$0 copay, $120 lenses allowance per year (for contacts OR glasses).
Life
Term Life & AD&D (Employee Only)
Term Life with AD&D (Employee ONLY)
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Guaranteed issue - up to $100,000. AD&D benefit that matches the benefit amount.
Life
Term Life & AD&D (Employee + Spouse)
Term Life & AD&D (Employee + Spouse)
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Maximum spouse election = 50% of employee benefit. All elections are relfective of spouse electing 50% of employee election, up to $25,000. Any election over $50,000 for employee only includes $25,000 benefit for spouse. Please contact us if you would like to elect more than the guaranteed issue amount.

Cancer
Cancer - Plan 1
Cancer - Plan 1
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$2,500 initial diagnosis benefit. $50 screening benefit. $10,000 annual chemotherapy. $300 per day hospital confinement (first 30 days)/$600 per day for 31st day thereafter. $400 per day ICU confinement (first 30 days)/$600 per day for 31st day thereafter.
Cancer
Cancer - Plan 2
Cancer - Plan 2
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$5,000 initial diagnosis benefit. $75 screening benefit. $15,000 annual chemotherapy. $300 per day hospital confinement (first 30 days)/$600 per day for 31st day thereafter. $400 per day ICU confinement (first 30 days)/$600 per day for 31st day thereafter.
Cancer
Cancer - Plan 3
Cancer - Plan 3
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$7,500 initial diagnosis benefit. $100 screening benefit. $15,000 annual chemotherapy. $400 per day hospital confinement (first 30 days)/$800 per day for 31st day thereafter. $600 per day ICU confinement (first 30 days)/$800 per day for 31st day thereafter.
Cancer
Cancer - Plan 4
Cancer - Plan 4
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$10,000 initial diagnosis benefit. $125 screening benefit. $15,000 annual chemotherapy. $400 per day hospital confinement (first 30 days)/$800 per day for 31st day thereafter. $400 per day ICU confinement (first 30 days)/$800 per day for 31st day thereafter.
Vision
Vision - Plan 2
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$0 copay ($120 allowance) for exam w/ dilation.$120 lenses allowance per year (for contacts OR glasses).
Hospital Indemnity
Hospital Indemnity
Hospital Indemnity - Plan 1
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$1,000 Admission Benefit - $100 per day benefit
Accident
Accident - Plan A
Accident Insurance - Plan A
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$50 health screening benefit. $500 one time hospital admission. $1,000 one time ICU admission. $200 per day hospital confinement/$400 per day ICU confinement. $2,500 non-surgical fracture/$5,000 surgical fracture repair. $25,000 Accidental death benefit.
Short Term Disability
Short Term Disability - Plan 1
Short Term Disability - Class 1
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Up to $2,000 weekly benefit (not to exceed 60% of income), 26 week benefit period, Injury and Sickness benefit begin the 8th day of missed work, Full Maternity Coverage
Short Term Disability
Short Term Disability - Plan 2
Short Term Disability - Plan 2
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Up to $2,000 weekly benefit (not to exceed 60% of income), 52 week benefit period, Injury and Sickness benefit begin the 8th day of missed work, Full Maternity Coverage
Short Term Disability
Short Term Disability - Plan 3
Short Term Disability - Plan 3
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Up to $2,000 weekly benefit (not to exceed 60% of income), 26 week benefit period, Injury and Sickness benefit begin the 15th day of missed work, Full Maternity Coverage
Short Term Disability
Short Term Disability - Plan 4
Short Term Disability - Plan 4
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Up to $2,000 weekly benefit (not to exceed 60% of income), 52 week benefit period, Injury and Sickness benefit begin the 15th day of missed work, Full Maternity Coverage
Accident
Accident - Plan B
Accident - Plan B
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$75 health screening benefit. $1,000 one time hospital admission. $1,500 one time ICU admission. $250 per day hospital confinement/$500 per day ICU confinement. $3,750 non-surgical fracture/$7,500 surgical fracture repair. $50,000 Accidental death benefit.
Accident
Accident - Plan C
Accident - Plan C
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$100 health screening benefit. $1,500 one time hospital admission. $2,250 one time ICU admission. $350 per day hospital confinement/$700 per day ICU confinement. $5,000 non-surgical fracture/$10,000 surgical fracture repair. $100,000 Accidental death benefit.
Critical Illness
Critical Illness
Critical Illness
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A lump sum pay-out benefit of up to $30,000, if insured is diagnosed with a Critical Illness. $50 wellness screening benefit. See the "information" tab for the diagnosis that qualify as a critical illness.
Vision
Dependent Care Vision Plan
Dependent Care Vision Plan
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$0 copay for exam w/ dilation.$120 lenses allowance per year (for contacts OR glasses).
Life
Term Life & AD&D - $10,000 Child(ren) Coverage
Term Life & AD&D - $10,000 Child(ren)
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$10,000 guaranteed issue for Child(ren)
Disability Insurance
Long Term Disability - Plan 1
Long Term Disability
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$6,000 monthly maximum (not to exceed 60% of earnings). 180 day elimination period. 3 month survivor Benefit.
Disability Insurance
Long Term Disability - Plan 2
Long Term Disability
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$6,000 monthly maximum (not to exceed 60% of earnings). 365 day elimination period. 3 month survivor Benefit.

Teamsters Local 1932

Teamsters Local 1932
VBS General Agency
909-312-5287

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