EXCLUSIONS AND LIMITATIONS
The Plan does not provide benefits for: any disability that occurs during or is due or related to intentionally self-inflicted injury while sane or insane, (MO residents: the exclusion for intentionally self-inficted injury is not applicable to injuries caused by an attempted suicide while insane) declared or undeclared war or any act thereof, military service, or your incarceration or participation in an illegal occupation/activity or the commission of a crime; or any disability that is due or related to pregnancy or childbirth (except complications thereof), or any impairment or disease specifically excluded from your coverage.
The Plan limits benefits for disabilities due to Mental Disorder or Chemical Dependency to a maximum of 24 monthly benefit payments.
No benefit will be paid unless the disability occurs while you are insured under the Plan and you are under the care of a licensed physician or surgeon other than yourself (or member of your immediate family or household) during the period of disability.
You will become insured on the date specified by New York Life Insurance Company provided the first premium contribution has been paid, satisfactory evidence of insurability has been submitted, and you are actively performing the normal activities of a person in good health on that date. [ Note: Residents of NC: Any reference to "performing normal activities of a person in good health" is replaced by the requirement that the health status of any proposed insured person remain the same as stated in your application. ] If you are not performing your normal activities as required, coverage will not become effective until the day you are performing such normal activities provided such date is within three months of the date insurance would have been effective and you are still eligible for insurance.
Payment of a premium contribution for insurance does not mean there is any coverage in force before the effective date as specified by New York Life Insurance Company.
There are instances where New York Life Insurance Company may be able to offer insurance, at the same cost, by eliminating coverage for a specific impairment or disease.
When Coverage Ends
Once coverage is validly in force, it may be continued to the premium due date on or immediately after you reach age 75, unless you: cease FULL-TIME WORK other then for reasons of disability; cease to be an ASME member; fail to pay premium contributions when due; enter full-time active duty in the armed forces (coverage may be restored upon termination of active duty status, subject to policy guidelines); or the group policy is terminated by the Trustee or New York Life Insurance Company.
Renewal Payments and Claims
Once you are accepted into the Plan, you will have a 31-day grace period for your payment of renewal premium contributions. When you want to submit a claim, call or write the Administrator for claim forms.
Certificate of Insurance
The information continued on this web site is only a brief description of the principal provisions and features of the Plan. The complete terms and conditions including features, costs, eligibility limitations and exclusions, are set forth in the group policy issued by New York Life Insurance Company to the Trustee under Trust Agreement with the ASME.
When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the Plan.
"30-Day Free Look"
If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will receive a full refund--no questions asked!
Who is Eligible
ASME members who are currently insured or applying for a Monthly Benefit Option of a least $600, and who are residents of the U.S. (except NC, VT, WA and territories) and Puerto Rico are eligible to request coverage for their lawful spouses under age 60.
How The Spouse Benefit Works
Benefits begin at the end of a 30 day waiting period, provided your spouse is Totally Disabled. A waiting period is the number of consecutive days your spouse must be Totally Disabled before benefits begin.
The Plan pays you a Monthly Benefit Option of $500, for up to two years, when your insured spouse is Totally Disabled. For the purpose of spouse benefits, the Group Policy defines "Totally Disabled" as being prevented by accident or sickness from performing the material and substantial duties of his/her usual occupation--whether for pay or profit or as a homemaker.
Plan Features for Spouse
Waiver for Premium If Totally Disabled:
During any period of time the premium contributions for member coverage are waived as a result of disability, the premium contributions for your spouse coverage will also be waived.
Your spouse may work outside the home, be employed by you or work in the home as a homemaker.
Benefits for Recurring Disability:
Successive periods of disability which are due to the same or related causes will be considered a single period of disability unless separated by a period of three continuous months or more during which your spouse returns to his/her occupation.
The insurance cost is based on your spouse's attained age when coverage becomes effective and increases as he/she reaches a higher age bracket.
Current Quarterly Premium Contribution For $500 Monthly Benefit Option of Spouse Coverage
| Spouse Age
| Under 35
*Renewal only. Coverage terminates on the premium due date on or immediately after the spouse reaches age 65.
The premium contributions shown reflect the current rates and benefit structure. Premium contributions may be changed by New York Life Insurance Company on any premium due date, but not more than once in any 12-month period, and on any date on which benefits are changed. However, your rates may change only if they are changed for all others in the same class of insureds under this group policy. For example, a class of insureds is a group of people all with the same issue age and tobacco/nicotine usage. Benefit option amounts are not guaranteed and are subject to change by agreement between New York Life Insurance Company and the Trustee.
Exclusions and Limitations
The policy's Exclusions and Limitations are the same for both member and spouse coverage.
You will become insured for spouse insurance on the date specified by New York Life Insurance Company provided the first premium contribution has been paid, satisfactory evidence of insurability has been submitted, you are insured, and your spouse is actively performing the normal activities of a person in good health on that date. [Note: Residents of NC: Any reference to "performing normal activities of a person in good health " is replaced by the requirement that the health status of any proposed insured person remain the same as stated in your application.] If he/she is not performing his/her normal activities as required, coverage will not become effective until the day he/she is performing such normal activities provided such a date is within three months of the date insurance would have been effective and he/she is still eligible for insurance.
When Coverage Ends
Once spouse coverage is validly in force, it may be carried to the premium due date on or immediately after your spouse reaches age 65, unless: premium contributions are not paid when due; your spouse becomes legally separated or divorced from you; or your coverage is terminated.
ASME is compensated in connection with this sponsored group plan to provide and maintain this valuable membership benefit.
This plan is underwritten by New York Life Insurance Company, on Policy Form GMR-G12501-2/FACE.
How to Apply
Be sure to review all of the life insurance information on the website
The Disability Income Protection Plan is medically underwritten based on the information provided by you on the application. It is important that you complete the form truthfully and completely. Your application is subject to New York Life Insurance Company approval and more medical information may be requested. A physical exam, EKG, blood test or other information may be required. If so, we will arrange for an independent professional paramedic to contact you to perform these simple tests at your convenience, free of charge.
- Refer to the Plan description for benefits and premium cost as you fill out the application.
- Make a check payable for the total amount of the premium contribution due payable to: Administrator, ASME Insurance Program.
Mail the completed request form with your check to:
ASME Insurance Program
12421 Meredith Drive
Urbandale, IA 50398
Consider Your Eligibility
Before you request coverage, you must be a member in good standing of ASME. Please wait until your application for membership is accepted before initiating your insurance requests. If you have any questions regarding membership, see the ASME home page.
Get Quicker, Easier Service When You Apply
The information provided when you fill out your request form can make the medical underwriting process quicker and easier. By providing complete and accurate information, you avoid delays that may occur while we wait for missing information to be received and shorten the time needed for underwriting decisions and approvals. We also request that you provide the following information for everyone you are requesting coverage on as well as on any named beneficiary: full name, address, date of birth, Social Security number, and telephone number. Please call 800-289-2763 to complete this request. If you prefer enclose a separate piece of paper with this information together with your application.
New York Life Insurance Company relies on your answers and statements. Misstatements or failures to report information on your request form may be used as the basis for denying or reducing claim benefits or even rescinding your insurance.