Underwritten by AXIS Insurance Company
Limited Fixed Indemnity Plan
First Health Network
The First Health Network is a discount program providing additional savings when participating providers and facilities are used for medical services. Any First Health discount applied to your medical service is in addition to your Legion Limited Medical Plan Coverage which pays a separate fixed indemnity benefit directly to you for covered medical services. This is not Insurance and is not provided by AXIS Insurance Company.
With your membership card you will have access to Network-participating providers, these can be searched 24 hours a day. Members should present their ID card each time they seek services from a participating provider to ensure they receive the full value of the First Health Network.
Disclaimer: The First Health Network is a discount program providing additional discounted savings when participating providers and facilities are used for medical services. This is not insurance. Any First Health discount applied to medical service is in addition to your insurance coverage which pays a separate fixed indemnity benefit directly to you for covered medical services. This is not insurance and is not provided by AXIS Insurance Company.
Limitations & exclusions
Benefits in connection with a Pre-existing Conditions occurring within the first twelve (12) months of coverage are not payable. "Pre-existing Condition" means an illness, disease, or other condition of the Covered Person, that was treated, diagnosed or required medications in the six (6) month period before the Covered Person's coverage became effective under this Policy. This Pre-Existing Condition Limitation shall not apply after the end of the Limitation Period shown in the Schedule of Benefits, commencing on the Insured Person's Coverage Effective Date.
In addition to any benefit or coverage specific exclusion, benefits will not be paid for any loss which directly or indirectly, in whole or in part, is caused by or results from any of the following unless coverage is specifically provided for by name in the Description of Benefits section of the insurance certificate:
In addition, benefits will not be paid for services or treatment rendered by any person who is:
Please note that certain words used in this Certificate have specific meanings. The words defined below and capitalized within the text of this Certificate have the meanings set forth below.
Accident or Accidental
means a sudden, unexpected, specific and abrupt event that occurs by chance at an identifiable time and place while the Insured Person is covered under this Policy.
Active Service/Actively at Work
The Member is considered in Active Service if He is none of the following:
means an Insured Person's age for purposes of initial premium calculations. It is His Age attained on the Coverage Effective Date for Him under this Certificate.
a vehicle which:
means AXIS Insurance Company.
means a plan for which the Insured Person pays a portion of the premium.
means an Accident that results in a Covered Injury during the Policy Term.
means bodily harm which results and independently from all other causes from a Covered Accident (independent of sickness, disease, mental incapacity, bodily infirmity or any other cause). All injuries sustained by an Insured Person in any one Accident, including related conditions and recurrent symptoms of these injuries, are considered a single injury.
means disease or illness, including related conditions and recurrent symptoms, which begins after the effective date of an Insured Person's coverage and while coverage is in force.
Coverage Effective Date
means the date shown on the Schedule of Benefits.
means the Primary Insured Person's unmarried child who meets the following requirements.
A Dependent Child, for purposes of this definition, includes the Primary Insured Person's:
If the Primary Insured Person who is the legal guardian of a child is not a step-parent, grandparent, aunt or uncle, then the child must have resided with Him for at least six consecutive months and intends to reside with Him for an indefinite period of time.
means the classes listed in the Schedule of Benefits.
means coverage in force under the Policy on a Primary Insured Person's Spouse and/or Dependent Children:
He, His, Him, You, Yours
refers to any individual, male or female.
means an Inpatient overnight Hospital Stay. Separate Hospital Stays due to the same Covered Injury or Covered Sickness will be treated as one Hospital Stay unless separated by at least 30 days.
an institution that meets all of the following:
The term Hospital does not include a clinic, facility, or unit of a Hospital for:
Immediate Family Member
means a person who is related to the Insured Person in any of the following ways: Spouse; brother-in-law; sister-in-law; daughter-in-law; mother-in-law; father-in-law; parent; siblings; (includes stepbrother or stepsister); grandparents or child (includes legally adopted or stepchild).
means confined overnight as a registered bed patient in a Hospital or other medical facility where at least one day's room and board is charged. The confinement must be on the advice of a Physician.
means a person in an Eligible Class, as defined in the Schedule of Benefits, for whom required premium has been paid when due and for whom coverage under this Policy remains in force. May include Insured Spouse and/or Insured Dependent Child covered under this Certificate.
means a Primary Insured Person's Dependent Child or a Primary Insured Person's Spouse, for whom premium is paid while covered under this Certificate.
Insured Dependent Child(ren)
means the Primary Insured Person's Dependent Child for whom premium is paid while covered under the Certificate.
means the Primary Insured Person's Spouse for whom premium is paid while covered under the Certificate.
Intensive Care Unit
means a hospital unit specifically staffed and equipped to provide intensive patient care.
means a condition caused by a Covered Accident or Covered Sickness that manifests itself by symptoms of sufficient severity that a prudent lay person possessing an average knowledge of health and medicine would reasonably expect that failure to receive immediate medical attention would place the health of the person in serious jeopardy.
means, for eligibility purposes, a member of the Policyholder who is in an Eligible Class as shown in the Schedule of Benefits.
means a licensed graduate registered nurse (R.N.) or a licensed practical nurse (L.P.N.) who is not:
means a licensed health care provider and/or Licensed Therapist practicing in the United States within the scope of His license and rendering care and treatment to the Insured Person that is appropriate for the condition and locality, and who is not:
means the time period defined in the Schedule of Benefits. The initial Plan Year may be less than 1 year (12 months). Subsequent Plan Years will be a full 12 month time period. Insured Dependents will have the same Plan Year as the Primary Insured Person.
Policy Effective Date
means the date the Policy takes effect for the Policyholder.
means the entity, named on the Policy's face page, to which the Company issues the Policy.
Primary Insured Person
means a person in an Eligible Class, as defined in the Schedule of Benefits, for whom, other than an Insured Spouse or Insured Dependent an enrollment form has been accepted by the Company and required premium has been paid when due and for whom coverage under the Policy remains in force.
means a disease or physical condition for which medical advice or treatment was received by the Insured Person during the 6 months prior to the Insured Person's Coverage Effective Date under this Certificate.
means an illness or disease which requires treatment by a Physician.
Schedule of Benefits
means the Schedule of Benefits in this Certificate.
means the Primary Insured Person's lawful spouse. The term Spouse will include Domestic Partner as permitted or required by law.
means the surgical treatment of fractured and dislocated bones, operations that involve cutting or incision and/or suturing of wounds or any other surgical procedure, that is:
We, Us, Our
means AXIS Insurance Company and its duly authorized agents.
means the person to whom this Certificate is issued.
About the association
Alliance For Consumers USA is a network of hard-working Americans; small business owners, hourly workers and the self-employed across our country. We are focused on educating and providing an array of programs and services that can help our member make sound financial, personal and health decisions.
Membership Benefits (Insurance benefits are available only to members of the association).
With their ACUSA membership, your clients will receive access to a Costco. They'll quickly discover why 87 million people are Costco members and receive coupons for free products exclusive to ACUSA members.
In today's digital world, our identities are compromised on many levels every day, including our social media profiles, pictures of family, and GPS locations. Your clients will have access to an exclusive discounted rate for Identity Guard, a service with monitoring products that provide the most complete view exposure of their personal information.
When a legal problem arises, your clients need immediate attention and the right choices to solve the problem as quickly as possible. LegalEASE's "we-do-it-for-you" attitude gives them the security to know they have help behind them when facing their legal problems. Attorney fees for legal needs are either 100% paid-in-full, partially paid, or offered at a discounted hourly rate when members work with a network attorney.
Long-Term Care Resources
As a leader in the long-term care insurance industry for almost 20 years, Long-Term Care Resources (LTCR) can offer your clients access to quality insurance as well as a wide choice of carriers, products (traditional and hybrid), and underwriting criteria.
Griswold® Home Care Elder Care
From referrals for options on such issues as senior living, VA benefits, hospice care, and more to determining appropriate home care services, Griswold® Home Care Elder Care can connect your clients with professionals who can provide much needed resources and advice.
This nationwide nonprofit is a free service that helps your clients to identify programs to alleviate the cost of their prescriptions and healthcare. It also provides members with a prescription discount card that allows savings up to 80% off cash prices.
Your clients can take charge of their health and fitness with direct access to major clinical labs for critical tests at discounted prices. The earlier medical conditions are detected, the easier and more likely they are to be treatable.
ACI Specialty Benefits Member Assistance Program
Through ACI's nationwide network of clinicians, life coaches, and work/life specialists, your clients and their families can receive comprehensive, personalized support for issue affecting emotional well-being via telephone or video chat sessions.
Your clients can take advantage of access to exclusive offers for full service travel and can earn spending credits toward shore and land excursions, airfare, and spa services through this membership benefit.
With access to this comprehensive resource, your clients can take advantage of digital tools such as home fitness programs, wellness articles, assessment calculators, and guidance on nutrition as they improve their personal fitness and manage their health conveniently.
Your clients can enjoy access to special discounts for auto and home coverage as well as take advantage of group discounts and exclusive valuable features and benefits.
The services described above are not insurance and are not provided by AXIS Insurance Company.
Short Term Medical Insurance
Limited Fixed Indemnity Plans