Essential Plan

Sun Life's Essential Plan offers extra money to employees and their loved ones who are injured in a covered accident. Our plan is affordable to employees at all levels of an organization, with a simple benefit schedule that's easy to understand.

How does it work?

Sun Life pays a cash benefit directly to the insured person injured as part of a covered accident. The amount we pay depends on the type of injury and care received, based on our benefits schedule. Benefits are payable multiple times, up to a Maximum Benefit Amount per covered accident.

Employees can use the money for any purpose, including:

Medical co-pays
Meeting high deductibles
Helping to replace a portion of wages due to time away from work

What's covered?

Sun Life's Essential Plan pays a benefit for:

Fractures and dislocations
Ambulance rides, hospital confinements, and emergency room and outpatient office visits
Medical devices
Accidental death and dismemberment (AD&D)

Looking for a more robust list of coverage? See our Accident, Preferred Plan.

Employees

Affordable
Guaranteed Issue, always
Family coverage
No reductions for other coverage
Composite rates (no age-branding)
HSA-compatible
Portable (subject to state availability)
Optional Accident Disability Insurance Benefit for the employee and spouse

Employers

Choice of up to 3 (among 7) benefit schedules to offer employees
Simple, easy-to-understand offering
Competitive group pricing
Appeals to younger workers, who may value accident over other coverage and also appreciate portability
Funding options: employee-paid, employer-paid, or shared cost
24-hour or off-job
Help employees achieve peace-of-mind knowing financial support is available
Value-added services that may be requested by employer:
- Emergency Travel Assistance
- Identity Theft Protection

Accident Insurance is a limited benefit policy. It provides accident coverage only. It does not provide basic hospital, basic medical, or major medical insurance. The certificate and its riders have exclusions and limitations that may affect any benefits payable. Benefits payable are subject to all terms and conditions of the certificate. The policy, certificate, and any rider, if applicable, may not be available in all states.

Group insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York, under Policy Form Series 12-GP-01, 12-AC-C-01, 12-AC-R-01, and 12-AC-R-02, subject to state availability. Product offerings may not be available in all states and may vary depending on state laws and regulations. Accident insurance is not available in New York.

Accident plans

The exclusions and limitations listed below may vary by state.

What exclusions apply to the benefits payable for both Accident Insurance and the Accident Disability benefits?

No benefits will be payable for any loss or Period of Disability that is a result of a Covered Accident that is due to or results from: war or an act of war, or any involvement in any period of any type of armed conflict (this does not include acts of terrorism); active military duty; riding in or driving any motor-driven vehicle in a race, stunt show, speed test or while Intoxicated; operating, learning to operate, serving as a crew member of, jumping or falling from any aircraft, including those which are not motor-driven (this does not include: 1) flying as a fare paying passenger in a scheduled or chartered flight operated by a commercial airline; or 2) flying as a passenger with no duties on board an aircraft operated by a private business to transport its personnel or guests); engaging in hang-gliding, bungee jumping, parachuting, sail gliding, parasailing, parakiting or any similar activities; participating in or practicing for any semi-professional or professional competitive athletic contest in which any compensation is received; committing of or attempting to commit an assault, felony or other criminal act; committing or attempting to commit suicide or injuring oneself intentionally; voluntary use of any controlled substance as defined in Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as now or hereafter amended, unless administered on the advice of a Physician and used as directed; improper or illegal use of inhalants or huffing; a Sickness or infection including physical or mental condition which is not caused solely by or as a direct result of a Covered Accident; an Injury arising out of or in the course of any work for pay or profit (if off-job coverage is elected); participation in a Riot, Rebellion or Insurrection (for Accident Disability Benefit only). Exclusions may vary depending on state requirements.

What limitations apply to the Accident Disability benefits payable?

Limitations include but are not limited to the following. No benefit is payable for any Period of Disability: while the insured is not under the Continuing Care of a Physician for the Injury causing the Disability, unless the insured has reached a maximum point of recovery and is still Disabled; for any period the insured does not submit to any medical examination or clinical assessment requested by us; for any Period of Disability during which the insured is incarcerated; for any period during which the insured would not receive regular pay from the Employer if the insured was not Disabled (any period during which benefits are suspended will not count towards the Maximum Benefit Duration).

SLPC 25143 07/13 (Exp: 07/15)

Sun Life Financial

Accident Insurance

Essential Plan

How does it work?

What's covered?

Employees

Employers