24 Hour Accident Limited Benefit Coverage

Accident Coverage for Members and their Families

• Helps pay your medical expenses for hospital   emergency room and confinement, doctor and surgeon,   lab test and x-rays, and ambulance • Accidental Death and Dismemberment benefits up to   $15,000 • Automatic acceptance through age 64 • Benefits are paid directly to you • You can choose any doctor or hospital • Choice of plan options: $7,500, $5,000 or $2,000

SCHEDULE OF BENEFITS

Maximums Per Accident Per Insured Member Option 1 Option 2 Option 3 Accidental Death & Dismemberment * $2,500 $10,000 $15,000 Maximum Medical Expense Benefit Paid Per Covered Accident $2,000 $5,000 $7,500 Deductible Per Accident $0 $100 $250 Hospital Confinement (Inpatient) $500 $1,250 $1,875 Physician’s Services (No Surgery) $500 $1,250 $1,875 Surgery (Includes Assistant Surgeon & Anesthesiologist Services) $500 $1,250 $1,875 Laboratory Expenses $200 $500 $750 Ambulance Services $200 $500 $750 X-Ray & Imaging Expenses $100 $250 $375 Emergency Room Services (Up to 3 visits per calendar year) $100 $150 $175 Monthly Cost - Single or Family ** $19.95 $29.95 $34.95

* Accidental Death & Dismemberment benefit for spouse and dependents are lower than amounts shown.

** Includes a $5.95 monthly administration fee.

VALUE BENEFITS OF AMERICA MEMBERSHIP ALSO INCLUDES DISCOUNTS AND DIVIDENDS *

The Dividend Club: Members will earn Dividends (paid quarterly to you) on Merchandise, Services, Travel & Entertainment when you shop from our On-line Mall and make a purchase. Choose from retailers like these, just to name a few, and get the dividends: Walmart.com, Target.com, BestBuy.com, CircuitCity.com, CompUSA.com, DisneyStore.com, OfficeMax.com, BrooksBrothers.com, Brookstone.com, Buy.com, EddieBauer.com, LizClairborne.com, FOA.com, FOSSIL.com, HotelDiscounts.com, Jcrew.com, etc.

Refund Sweepers: Free Merchandise, Bargains, On-line Coupons, Rebates, Sweepstakes & more

Car Rental Services: Provides discounts at Alamo, National, Hertz and Avis

Rewards Network: America’s Premier Dining Rewards Program and Hotel Discounts. Save up to 20% off every meal plus up to 15% off your hotel room rate

Included at no charge: discounts at over 55,000 pharmacies for your prescription drugs as well as lab tests and x-ray imaging services

Discount Benefits Are Not Insurance

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BENEFITS DETAILS

BENEFITS DETAILS

Accident Medical/Dental Expense Benefits:

After the satisfaction of the accident deductible: Option 1: No deductible Option 2: $100 Option 3: $250

The insurance company will pay Accident Medical/Dental Benefits described below for Covered Expenses that result directly, and from no other cause, from a Covered Accident. The most they will pay for all Accident Medical/Dental Benefit expenses incurred for each Covered Accident is based on the membership level chosen:

Option 1 is $2,000, Option 2 is $5,000 or Option 3 is $7,500

The first Covered Expenses must be incurred within 90 days of the Accident. Accident Medical/Dental Benefits are only payable: (1) for Usual and Customary Charges incurred; (2) for those Medically Necessary Covered Expenses incurred by or on behalf of the Covered Person; and (3) for charges incurred within 365 days after the date of the Covered Accident. No benefits will be paid for any expenses incurred that, in their judgment, are in excess of Usual and Customary Charges.

Covered Expenses:

1. Inpatient Hospital Benefit: Option 1 is $500, Option 2 is $1,250 and Option 3 is A $1,875 for Hospital Room and Board Expenses if the Covered Person requires a Hospital Stay due to a Covered Accident. This consists of the daily room rate when the Covered Person is Hospital Confined and general nursing care is provided and charged for by the Hospital. 2. Doctor’s Services Benefit: Option 1 is $500, Option 2 is $1,250 and Option 3 is A $1,875 for  Doctor’s expenses incurred during the treatment of a Covered Accident. 3. Surgical Benefit: Option 1 is $500, Option 2 is $1,250 and Option 3 is A $1,875 for Surgical and Anesthesia expenses incurred when a Covered Person receives Surgery for the treatment of a Covered Accident. 4. Laboratory Services Benefit: Option 1 is $200, Option 2 is $500 and Option 3 is $750 for laboratory expenses incurred for the diagnosis and treatment of a Covered Accident. 5. Ambulance Benefit: Option 1 is $200, Option 2 is $500 and Option 3 is $750 for ambulance transportation expenses incurred if the Covered Person receives ambulance transportation by air or ground, to or from a Hospital.  The ambulance services provided must be for transportation: 1) To the nearest Hospital that is able to provide appropriate care; or 2) From the Hospital to a Covered Person’s residence or another medical facility  that is required for treatment of the Covered Person’s condition. 6. X-Ray Benefit: Option 1 is $100, Option 2 is $250 and Option 3 is $375 for X-Ray expenses incurred for the diagnosis and treatment of a Covered Accident. 7. Emergency Room Benefit: Option 1 is $100, Option 2 is $150 and Option 3 is $175 for Emergency Room expenses incurred for Medical Emergency Care administered within 72 hours of a Covered Accident, to a maximum of 3 visits per calendar year.

Accidental Death & Dismemberment Benefits:

The insurance company will pay the benefit shown below if Injury or Death occurs due to a Covered Accident, 24 hours a day, anywhere in the world, subject to the limitations listed below. If the Injury results in any of the following losses within 365 days after the date of the Covered Accident, they will pay the amount shown below for that loss. If multiple losses occur, only one Benefit Amount, the largest, will be paid for all losses due to the same Covered Accident.

Covered Loss Indemnity Life; Both Hands or Both Feet; Sight of Both Eyes Principal Sum One Hand and One Foot; Either Hand or Foot and Sight of One Eye Principal Sum Either Hand or Foot, or Sight of One Eye 50% of the Principal Sum Thumb and Index Finger of the Same Hand 25% of the Principal Sum

"Loss of Hand or Foot" means complete Severance through or above the wrist or ankle joint. "Loss of Hand" includes "Loss of Four Fingers of the Same Hand." "Loss of Sight" means the total, permanent Loss of Sight of one eye that is irrecoverable by natural, surgical or artificial means. "Loss of a Thumb and Index Finger in the Same Hand" or "Loss of Four Fingers of the Same Hand" means complete Severance through or above the metacarpophalangeal joints of the same hand (the joints between the fingers and the hand). "Severance" means the complete separation and dismemberment of the part from the body.

Principal Sum for membership levels: Option 1 $2,500, Option 2 $10,000 or Option 3 $15,000

Family Plan Coverage (if family program is elected):

The Member’s Spouse is automatically insured for 50% of the Principal Sum (the amount increases to 60% if there are no dependent children); each Dependent child is automatically insured for 20% of the Principal sum (increases to 25% if no Spouse).

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VBA TERMS

VBA TERMS AND CONDITIONS

1. Member understands that VBA is not an insurance company or program. Accident Benefit Payments are made by the administrator for the insurance company issuing the blanket coverage to Members. 2. VBA provides savings to its members on services through a number of sources. The current list of benefits may be modified through additions or deletions. A quarterly newsletter, posted on our website or sent via e-mail, will keep Members up to date on benefits and other pertinent information. 3. Payments for the VBA Program are due in advance. Payments will be drafted on or about 15 days before the due date. If you choose to cancel your program, it is your responsibility to make sure that your membership card and a written request for cancellation are sent to VBA at least 15 days prior to the anniversary of your effective date in order for your account not to be charged for additional fees. 4. Member hereby appoints, Value Benefits of America Association (VBA) President, or failing this person, a VBA Director, as proxy holder for and on behalf of the member with the power of substitution to attend, act and vote for and on behalf of the member in respect of all matters that may properly come before the meeting of the members of VBA and at every adjournment thereof, to the same extent and with the same powers as if the undersigned member were present at the said meeting, or any adjournment thereof. Annual meetings are to be held in Arizona the second Tuesday of August. 5. VBA reserves the right to terminate any enrollment or deny eligibility in the program for lack of payment to VBA. Returned checks, insufficient notices on bank drafts or denial by the member’s credit card company for payment of the membership fee is deemed to be evidence of non-payment by a member. There will be a $10.00 charge to be reinstated in the program after such denial. If reinstatement for non-payment happens more than once, a $20.00 reinstatement will apply. 6. In the event of any dispute, member agrees to resolve said dispute solely by binding arbitration that shall be governed by the laws of the state of Arizona and enforceable at Scottsdale, Maricopa County. 7.Membership cancelled within the first 30 days of the enrollment date may be eligible for refund if the membership card and written cancellation request are sent to VBA. The administrative fee is not refundable. Approved refunds will be processed approximately 30 days after cancellation. 8. Membership is effective on the 1st of the month following enrollment acceptance by VBA. Member Agreement: By signing your enrollment form, Member expresses desire to become a member of Value Benefits of America. Member acknowledges that the discount plans ARE NOT INSURANCE, but membership includes certain limited supplemental insured coverage's. Membership benefits are not a replacement for health insurance coverage nor are they intended as a substitute for health insurance coverage. Membership fees may change for all members, but not individually, with notification.

Discount Benefits Are Not Insurance

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DEFINITIONS

Accident means a sudden, unexpected and unintended event occurring external to the Covered Person.

Covered Accident means an Accident that which benefits are payable.

Covered Person means any Eligible Person and Eligible Dependent (if family program is elected) for whom the required premium is paid.

Deductible means $100 or $250 of Covered Expenses that must be incurred as an out-of-pocket expense by each Covered Person per Accident before Accident Medical/Dental Expense Benefits are payable under the Group Policy. Doctor means a licensed health care provider acting within the scope of his or her license and rendering care or treatment to a Covered Person that is appropriate for the conditions and locality. It will not include a Covered Person or a member of the Covered Person’s Immediate Family or household.

Eligible Dependent means an Insured’s lawful spouse under the age of 65; or an Insured’s unmarried child, from the moment of birth to age 19 (25 if a full-time student), who is chiefly dependent on the Insured for support. A child, for eligibility purposes, includes an Insured’s natural child; adopted child, beginning with any waiting period pending finalization of the child’s adoption; or a stepchild who resides with the Insured or depends on the Insured for financial support. Insurance will continue for any dependent child who reaches the age limit and continues to meet the following conditions: 1) the child is handicapped; 2) is not capable of self-support; and 3) depends mainly on the Insured for support and maintenance. The Insured must send us satisfactory proof that the child meets these conditions, when requested. We will not ask for proof more than once a year.

Immediate Family means a Covered Person’s parent, grandparent, spouse, child, brother, sister, stepchild, grandchild, step-grandchild or in-laws.

Injury means accidental bodily harm sustained by a Covered Person that results directly and independently from all other causes from a Covered Accident. The Injury must be caused through accidental means. All injuries sustained by one person in any one Accident, including all related conditions and recurrent symptoms of these injuries, are considered a single Injury.

Insured means a person in a Class of Eligible Persons for whom the required premium is paid making insurance in effect for that person. An Insured is not an Eligible Dependent covered under the Policy. The Insured is referred to as "You" or "Your(s)."

Hospital means an institution that: 1) operates as a Hospital pursuant to law for the care, treatment, and providing of in-patient services for sick or injured persons; 2) provides 24-hour nursing service by Registered Nurses on duty or call; 3) has a staff of one or more licensed Doctors available at all times; 4) provide organized facilities for diagnosis, treatment and surgery, either: (i) on its premises; or (ii) in facilities available to it, on a pre-arranged basis; 5) is not primarily a nursing care facility, rest home, convalescent home, or similar establishment, or any separate ward, wing or section of a Hospital used as such; and 6) is not a place for drug addicts, alcoholics, or the aged.

Hospital Confined or Hospital Stay or Confined to a Hospital means a stay of 24 or more consecutive hours as a registered resident bed-patient in a Hospital.

Medical Emergency means a condition caused by an injury 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.

Medically Necessary means a treatment, service or supply that is: 1) required to treat an Injury; 2) prescribed or ordered by a Doctor or furnished by a Hospital; 3) performed in the least costly setting required by the Covered Person’s condition; and 4) consistent with the medical and surgical practices prevailing in the area for treatment of the condition at the time rendered. Purchasing or renting: 1) air conditioners; 2) air purifiers; 3) motorized transportation equipment; 4) escalators or elevators in private homes; 5) swimming pools or supplies for them; and 6) general exercise equipment are not Medically Necessary. A service or supply may not be Medically Necessary if a less intensive or more appropriate diagnostic or treatment alternative could have been used. We may, at Our discretion, consider the cost of the alternative to be the Covered Expense.

Mental or Nervous Disorder means a neurosis, psychoneurosis, psychopathy, psychosis, or mental or emotional disease of any kind that is without demonstrable organic cause.

Usual and Customary Charge means the average amount charged by most providers for treatment, service or supplies in the geographic area where the treatment, service or supply is provided.

G-19001-DEF

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Exclusions and Limitations

We will not pay benefits for any loss or Injury that is caused by, results from, or is contributed to by:

1. Intentionally self-inflicted Injury, suicide or attempted suicide, while sane. 2. War or any act of war, whether declared or not. 3. Active participation in a riot or insurrection. 4. Service in the military, naval or air service of any country, or international organization. 5. Piloting or serving as a crewmember or riding in any aircraft except as a fare-paying passenger on a regularly scheduled or charter airline. 6. Work related injuries covered under Worker’s Compensation, Employer’s Liability Laws, or similar occupational benefits 7. Medical mishap or negligence, including malpractice 8. While traveling outside the United States, Canada, Mexico, or any United States possessions, except for a Medical Emergency or a covered Accidental Death or Accidental Dismemberment. 9. Treatment provided in a governmental hospital, benefits provided under a government program (except Medicaid or Medicare), and any other services for which no charge is normally made in the absence of insurance. 10. Treatment by an Immediate Family member or a member of the Covered Person’s household. 11. Alcoholism, drug addiction or the use of any drug or narcotic except as prescribed by a Doctor. 12. Cosmetic care, except for Medically Necessary reconstructive plastic surgery. Reconstructive plastic surgery is defined as: a. Surgery to restore normal bodily functions; or b. Surgery to improve functional impairment by anatomic alteration made necessary as a result of a congenital birth defect; or c. Breast reconstruction following a mastectomy. 13. Dental treatment, except for Injury to sound, natural teeth. 14. Hernia, adenoids, tonsils, varicose veins, appendix, disorder of the reproductive organs, voluntary abortion, or elective sterilization with 6 months after the Covered Person’s effective date of insurance. 15. Rest care, convalescent care, or rehabilitative care. 16. Treatment of Mental or Nervous Disorders.

In addition to the General Exclusions, we will not pay benefits for Injury or death to which a contributing cause is:

1. The Covered Person’s violation or attempt to violate any duly-enacted law, or the commission or attempt to commit an assault or a felony, or that occurs while the Insured is engaged in an illegal activity or occupation. 2. Injury or death from an Accident where the Covered Person’s intoxication would be considered a contributing cause to the Accident. Intoxication is determined according to the laws and/or regulations of the jurisdiction in which the Accident occurred. It will be considered a contributing cause if: a. An investigation into the cause of the Accident by a police department or other government body makes such determination; or b. It meets a “prudent and reasonable” test. “Prudent and reasonable” means that a review of the circumstances of the Accident by an ordinarily prudent person would find that the most reasonable interpretation of the facts indicate that intoxication was a causal factor. 3. Loss for which the Covered Person would not be responsible in the absence of this Coverage.

In addition to the General Exclusions, Accident Medical/Dental Expense Benefits will not be paid for:

1. Treatment of hernia, Osgood-Schlatter’s Disease, osteochronditis, appendicitis, osteomyelitis, cardiac disease or conditions, pathological fractures, congenital weakness, or detached retina unless caused by Injury, whether or not caused by a Covered Accident. 2. Pregnancy, childbirth, miscarriage, abortion or any complications of any of these conditions. 3. Mental and Nervous Disorders (except as provided in the Group Policy). 4. Damage to or loss of dentures or bridges, or damage to existing orthodontic equipment (except as specifically covered by the Group Policy). 5. Expense incurred for treatment of Temporomandibular or Craniomandibular joint dysfunction and associated myofacial pain (except as provided by the Group Policy). 6. Covered medical expenses for which the Covered Person would not be responsible in the absence of this Coverage. 7. Any expense paid or payable by any other valid and collectible group insurance plan. 8. Conditions that are not caused by a Covered Accident. 9. Any treatment, service or supply not specifically covered by the Group Policy. G-19001-GE

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FAQ

FREQUENTLY ASKED QUESTIONS   When will my benefits become effective? All effective dates are the 1st of the month following your enrollment.   Do the accident expense benefits coordinate with other coverage? Yes, the benefits are secondary to other coverage and will coordinate with other insurance.   Do I have benefits outside of the United States? Yes, if you are traveling for pleasure outside of the United States you will be eligible for benefits.   What is the maximum age for accident benefits? At age 65 the accident benefits are no longer available to VBA members.   Are dependents eligible as members? Yes, a spouse under age 65 and dependent children to age 19 or full time student under age 25.   Is there a limit to the number of accidents per year that are covered? No, the benefits are paid on a per accident occurrence.   What are the payment options? You may pay by monthly credit card or monthly automatic bank draft.   What other benefits are available to me as a VBA member? There are many valuable benefits as a VBA member that you will receive in your fulfillment packet or can preview on this web site.   What if I have questions regarding the benefits after I enroll? You can contact your agent or call our toll free customer service line.

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Security and Privacy Statement

When you become a GACquote.com customer, you entrust us with your personal data. We consider your data to be private and confidential, and we hold ourselves to the highest standards of trust and fiduciary duty in their safekeeping and use. General Agent Center (GAC) and our partners will not release information about you or your application, policy or claims information, unless one or more of the following conditions are met: We receive your prior written consent. We believe the prospective recipient to be you or your authorized representative. We are required by law to release information to the recipient. Questions about your medical history and physical condition are required by our insurance carrier partners and will be released to the insurer so that they may underwrite your insurance application. GAC will not give or sell information about you to any other company, individual, or group without your prior authorization. GAC will only use information about you to help us better serve your insurance needs or to suggest GAC services or insurance materials that may be of interest to you. To further protect your privacy, our web site uses the highest levels of Internet security, including data encryption, user names and passwords, and other security tools. Occasionally, GAC may conduct marketing surveys or research to help us evaluate products, services, and the changing needs of our customers. It is GAC's policy to keep this information confidential. We will not share individual marketing data gathered from our web site with individuals or business entities not affiliated with GAC. We know that the privacy of your personal information is important to you. In order to provide you with insurance products of the highest quality and with the service you deserve, it may be necessary for us from time to time to collect nonpublic personal and financial information about you (the "Information") and, in certain situations, to share that Information with others. The following notice describes our policies and practices with regard to your Information.

HOW WE PROTECT YOUR INFORMATION

We maintain physical, electronic and procedural safeguards to protect the Information against unauthorized access and use. We restrict access to the Information to those employees who need access to provide products and services to you and your dependents. The personnel who have access are trained in the proper handling of the Information. Employees who violate this strict level of confidentiality are subject to our disciplinary process.

CATEGORIES OF INFORMATION THAT WE COLLECT

In the normal course of business we may collect the following types of Information: Information you provide on applications and other forms (including name and address) Data about your transactions with us (such as types of products you have purchased and your account status) Information gathered on our Web sites through online forms, site visit data and online information-collecting devices known as "cookies"

HOW WE USE YOUR INFORMATION

We may share your information among the Insurance Companies as permitted by law, including for routine business administration. We may share information with non-affiliated companies as allowed by law, such as firms that perform services on our behalf, including the administration and marketing of our products. We require these companies to meet strict privacy standards. We may disclose information to non-affiliated entities when required by law, such as to respond to a subpoena, to prevent fraud or to comply with an inquiry by a government agency.

ACCURACY OF YOUR INFORMATION

We strive to maintain the accuracy of Information that is in our possession about you. In order to help us maintain accuracy, you have the right to reasonably access your information. If you believe any information in our possession is inaccurate, a request can be made to amend or delete the information that you believe to be erroneous. If we concur with the request, we will amend or delete the information in question. You may write our Privacy Office at the address below to receive our complete policy on accessing and amending the Information.

CHANGES TO THIS NOTICE

We reserve the right to change this Notice. We reserve the right to make the revised Notice effective for the Information we already have about you as well as any Information we receive in the future. If we make any material changes to our policies or practices, we will provide you with a copy of a revised Notice. We will post a copy of the current Notice on our websites. The Notice will contain in the top right-hand corner, the effective date.

You may contact our Privacy Office at:

1-800-544-9505