administrator asme group insurance … 44079/44080/1004 /52254 epsmoore_asme-44079-catastrophicdip...
TRANSCRIPT
0000333-0000001-0000210
44079/44080/1004 /52254
epsmoore_asme-44079-catastrophicdip
American Society of Mechanical Engineers
Unimerica Insurance Company
Association Administrative Address:
P.O. Box 17828, Portland, Maine 04112-8828
Group Policy Number: 1152
TO APPLY:
Send this completed form to:
ADMINISTRATOR
ASME GROUP INSURANCE PROGRAM
P.O. BOX 10374
Des Moines, IA 50306-8812
QUESTIONS?
Call: 1-800-289-ASME(2763)
Member of American Society of Mechanical Engineers
Employee of Member of ASME
0000334-0000002-0000210
*01660801000*
0000335-0000003-0000210
0000336-0000004-0000210
*01670802000*
0000337-0000005-0000210
Mercer Consumer.
0000338-0000006-0000210
THIS PAGE IS INTENTIONALLY LEFT BLANK.
*01680803000*
0000339-0000007-0000210
0000340-0000008-0000210
THIS PAGE IS INTENTIONALLY LEFT BLANK.
*01690804000*
0000341-0000009-0000210
0000342-0000010-0000210
THIS PAGE IS INTENTIONALLY LEFT BLANK.
*01700805000*
0000343-0000011-0000210
FOR MEMBERS OF ASME OR EMPLOYEES OF MEMBERS
ASME's Catastrophic Disability insurance helps you
keep control of your life, and your future. It will help
pay the burdensome costs of assisted living, whether it's
in a facility or your home, so you don't have to
sacrifice your future, or your loved ones'.
Disability income insurance you may have from work
makes up part of your missing paycheck. But it may
not be enough to cover expenses for visiting in-home
nurses, or for skilled care in an assisted-living facility.
The ASME Catastrophic Disability Plan can offer a
flexible, affordable safety net.
Catastrophic Disability insurance is available to
ASME members or employees of members under
age 55 and who are actively at work; reside in the
United States, and earning a minimum of $12,000
per year.
This plan is not currently available in all states, for
details, call 1-800-289-ASME(2763).
0000344-0000012-0000210
*01710806000*
0000345-0000013-0000210
If applicable, an additional $2 billing fee will be included on
your billing notice payable to the administrator. To save the fee,
select Electronic Funds Transfer (EFT) as a safe and secure
payment option.
0000346-0000014-0000210
*01720807000*
ASME, or an employee
of a member.
1-800-289-ASME(2763).
0000347-0000015-0000210
1. Complete and sign the Application.
2. Do not send any money until Unimerica Insurance
Company has approved your Application and notifies
you of the premium contribution due, based on the
information you have provided.
3. Mail your completed Application to:
ASME Group Insurance Program
P.O. Box 10374
Des Moines, IA 50306-8812
The Group Insurance Program Is Administered by:
Mercer Consumer, a service of Mercer Health &
Benefits Administration LLC
ASME Group Insurance Program
P.O. Box 10374
Des Moines, IA 50306-8812
Toll-free 1-800-289-ASME(2763)
http://www.asmeinsurance.com
AR Insurance License #100102691
CA Insurance License #0G39709
In CA d/b/a Mercer Health & Benefits
Insurance Services LLC
The Catastrophic Disability Income Plan is
Underwritten by:
Unimerica Insurance Company
(in California, dba Unimerica Life Insurance Company)
Association Administrative Address:
P.O. Box 17828
Portland, ME 04112-8828
Home Office:
10701 West Research Drive, Milwaukee, WI 5322
Copyright 2018 Mercer LLC. All rights reserved.
ADR594-2010 2/15
CDP1664
0000348-0000016-0000210
THIS PAGE IS INTENTIONALLY LEFT BLANK.
*01730808000*