Terms

Effective Date of Coverage: Insurance will take effect on the first of the month on or following the date your application is approved by New York Life Insurance Company, provided the initial contribution is paid within 31 days after you are billed and any person to be insured is actively at work performing normal activities of a person in good health of like age on the day of approval. If any dependent proposed for coverage is not performing his/her normal activities as required, coverage will not take effect until he/she is performing such activities provided such date is within three months after the date insurance would have been effective and the person is still eligible.

When Coverage Ends: Coverage will end when the insured person reaches age 75, or earlier if: (a) the premiums are not paid when due, (b) the AOA membership ends, (c) the group coverage is terminated or modified by the policyholder or New York Life Insurance to end insurance for the group of insureds to which the member belongs, (d) When you begin active duty in the armed forces (e) if the insured requests to terminate insurance, and (f) the date the insured person no longer incurs Covered Expenses for Business Overhead Expense Insurance due to the dissolution of his/her association with the business office facility on which benefit payment is based.

This website contains only a general description of the principal provisions, definitions and limitations of the insurance. The complete terms and conditions are set forth in the Group Policy issued by New York Life Insurance Company for the members of the AOA under Group Policy G-29336-3. Please refer to the Certificate of Insurance used to all approved insureds.

EXCLUSIONS:

The AOA Group Business Overhead Expense Insurance does not cover and we will not pay a benefit for any loss or disability: 1) due to engagement in an act or accident of war or act of war, other than as a victim, an armed conflict which involves the armed forces of one or more countries.2) due to an act of suicide while sane or intentionally self-inflicted injury while sane; 3) due to participation in a felony; an illegal occupation or activity; an insurrection; terrorist activity; or a riot. 4) due to pregnancy (except that Complications of Pregnancy are covered); 5) due to injury sustained during travel in, travel on, fall from or descent from any aircraft while such aircraft is in flight unless the INSURED MEMBER is traveling: (a) solely as a fare paying passenger on a licensed, commercial, regularly scheduled, non-military aircraft; or (b) in a civil aircraft having a current and valid “Standard Federal Aviation Agency Airworthiness Certificate” and piloted by a person with a current and valid pilot’s certificate with proper ratings for the type of flight and aircraft involved. 6) A disability that is due to or related to service in the military, naval or air force of any country, alliance or international organization or in a civilian unit which serves such force.

Impairment Restriction means a disability that is due to or related to a condition which has an Impairment Restriction. However, at any time and at his or her own expense, the INSURED MEMBER can give medical evidence of insurability for a condition which has an Impairment Restriction. After review of such evidence, New York Life will determine: (a) if and when such Impairment Restriction should be removed or liberalized or (b) if it should be continued. “Impairment Restriction” means an exclusion or limitation of insurance on an INSURED MEMBER. An Impairment Restriction will be: (a) established by New York Life; and (b) continued by New York Life if it is in effect on the day before; (1) the INSURED MEMBER becomes insured under the Policy; or (2) a change in insurance takes effect; whether or not satisfactory medical evidence of insurability is furnished or medical evidence of insurability of required. All Impairments Restrictions are stated in the certificate. Insurance with such Impairment Restrictions is subject to the APPLICANTS acceptance. Payment of one CONTRIBUTION after the INSURED MEMBER is advised of the Impairment Restrictions will establish such acceptance.

Excluded expenses include:
Employees Salaries: The salaries of individuals hired after the insured’s total disability began.

The listing of your coverage including exclusions or limitations can be found in the group policy/certificate. If differences exist between this summary and the policy/certificate, the policy/certificate will govern. This program may vary and may not be available to residents of all states. Additional exclusions may apply as a condition of approval of your application for coverage.

Important Definitions

Total Disability means one that begins while insured and continuously disables he/she so that he/she is unable to perform all the substantial and material duties of his/her occupation. Also, he/she must be under a doctor’s regular care and not working at any gainful occupation for wage or profit.

A loss of license, in and of itself, does not constitute an incapacity that prevents the insured member from doing the material and substantial duties of his/her occupation and will not be deemed a total disability.

Successive Periods of Disability will be considered one period of disability if such disabilities are due to the same or related causes, and which are separated by less than three months of return to continuous full-time work during which you are not totally disabled or different or unrelated causes are not separated by return to full-time work.

Full-time work means the active performance for pay or profit of the regular duties of one’s normal occupation on a basis of 20 hours per week at a place where such duties are normally performed or other location to which travel is required.

Important Information from New York Life Insurance Company

New York Life Insurance Company reserves the right to request medical information to determine applicant’s medical eligibility for coverage. Based on the age of the person proposed for insurance and the amount of coverage requested, a physical examination, EKG, blood test or other information may be required. Not all applicants will have to supply additional information. However, if it is required, New York Life will arrange for an independent professional paramedic to contact you to perform these simple tests at your convenience. The exam and blood test are free-of-charge.

If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life.

IMPORTANT NOTICE:

How New York Life Obtains Information and Underwrites Your Request For Group Business Overhead Expense Insurance
In this notice, references to “you” and “your” include any person proposed for insurance. Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualify for insurance , we will rely on the medical information you provide, and on the information you AUTHORIZE us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, Inc. (“MIB”). MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. If you apply for life or health insurance coverage, a claim for benefits is submitted to an MIB member company, medical or non- medical information may be given to MIB, and such information may then be furnished by MIB, upon request, to a member company.

Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application for insurance, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying New York Life in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.

MIB and other insurance companies may also furnish New York Life, its subsidiaries or the Plan Administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other applications for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.

New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing, however, this will not be done in connection with test results concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but we will not disclose our underwriting decision.

New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a “need to know” basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.

If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB’s information office is: MIB, Inc., 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 866- 692-6901. For Canadian residents, the address is: MIB Information Office, 330 University Avenue, Suite 501, Toronto, Ontario, Canada M5G 1R7, telephone 416-597-0590. Information for consumers about MIB may be obtained on its website at www.mib.com.

For NM Residents: PROTECTED PERSONS ¹ have a right of access to certain CONFIDENTIAL ABUSE INFORMATION² we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.

¹ PROTECTED PERSON means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured person or prospective insured person.

²CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.

New York Life Insurance Company 8.12 ed.

If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life.

Questions? Call toll-free 1-866-331-0180

When program experience has been good New York Life Insurance Company will periodically return excess premiums in the form of dividends to the AOA as the policyholder. The AOA will retain these dividends in a Dividend on Deposit Account with New York Life. The AOA will in turn periodically make these dividends available through premium credits to existing insureds in the programs which generated the dividends. Sufficient reserves will be retained by the AOA in the Dividend on Deposit Account to cover administrative and marketing costs generated by the New York Life Insurance Programs sponsored by the AOA. These programs are administered together to take advantage of the savings resulting from this integrated approach.

Administrative expenses incurred by the AOA to provide the valuable membership benefits resulting from these sponsored insurance programs are reimbursed from available program dividends, however they are not guaranteed. New York Life may also, out of premium, pay a reasonable fee to the AOA for making AOA assets available to it to promote these programs to the membership. These assets include the AOA Intellectual Property Rights and mailing lists of eligible members.

Endorsed By: The AOA


Administered by:
AGIA Insurance Services, Inc.
P.O. Box 26860
Phoenix, AZ 85068



A.G.I.A., Inc., is licensed/authorized to transact business in all 50 United States, and the District of Columbia. Their state of domicile is California. Matthew Bishop California Agent insurance license number is 0F00863. Matthew Bishop Arkansas Agent insurance license number is 8493373.

The Group Business Overhead Expense Insurance is underwritten by:
New York Life Insurance Company
51 Madison Avenue, New York, NY 10010
under Group Policy G-29336-3 on
Policy Form GMR-FACE/ G-29336-3

New York Life is licensed/authorized to transact business in all the 50 united states, District of Columbia and Puerto Rico. Please note that this coverage is not available in all states.
New York Life Insurance Company’s state of domicile is New York and their NAIC ID # is 66915.

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